Polyclonal Immunoglobulin Recovery after Autologous Stem Cell Transplantation Is an Independent Prognostic Factor for Survival Outcome in Patients with Multiple Myeloma
Abstract
:1. Introduction
2. Results
2.1. Patients’ Characteristics
2.2. Polyclonal Ig Recovery after ASCT
2.3. Polyclonal Ig Recovery and Bone Marrow Plasma Cells
2.4. Survival Outcome
2.5. Univariate and Multivariate Analysis
3. Discussion
4. Materials and Methods
4.1. Patients and Treatment
4.2. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristic | All Ig recovery (n = 26) | Not all Ig recovery (n = 24) | Total (n = 50) | p |
---|---|---|---|---|
Median age (range) | 58 (39–71) yrs | 56 (35–69) yrs | 57 (35–71) yrs | 0.16 |
Gender (M/F) | 11/15 | 12/12 | 23/27 | 0.78 |
M protein | 0.89 | |||
IgG | 11 | 13 | 24 | |
IgA | 6 | 3 | 9 | |
IgD | 1 | 1 | 2 | |
BJP | 7 | 6 | 13 | |
Non-secretory | 1 | 1 | 2 | |
Hemoglobin | 0.74 | |||
Normal | 12 | 10 | 22 | |
Low (<10g/dL) | 7 | 9 | 16 | |
Unknown | 7 | 5 | 12 | |
Serum creatinine | 1.00 | |||
Normal | 19 | 21 | 40 | |
High (>2mg/dL) | 1 | 1 | 2 | |
Unknown | 6 | 2 | 8 | |
Serum calcium | 1.00 | |||
Normal | 17 | 16 | 33 | |
High (>11mg/dL) | 2 | 3 | 5 | |
Unknown | 7 | 5 | 12 | |
Lytic bone lesion | 0.20 | |||
0 | 4 | 8 | 12 | |
1–3 | 6 | 7 | 13 | |
>3 | 16 | 9 | 25 | |
ISS stage | 0.48 | |||
I | 10 | 6 | 16 | |
II | 10 | 10 | 20 | |
III | 5 | 8 | 13 | |
Unknown | 1 | 0 | 1 | |
R-ISS stage | 0.036 | |||
I | 8 | 1 | 9 | |
II | 13 | 12 | 25 | |
III | 1 | 4 | 5 | |
Unknown | 4 | 7 | 11 | |
Induction regimen | 0.56 | |||
VAD | 9 | 11 | 20 | |
Novel agent-based | 17 | 13 | 30 | |
Response before ASCT | 0.11 | |||
sCR | 3 | 2 | 5 | |
CR | 5 | 1 | 6 | |
VGPR | 7 | 4 | 11 | |
PR | 11 | 13 | 24 | |
SD | 0 | 4 | 4 | |
Response after ASCT | 0.36 | |||
sCR | 9 | 5 | 14 | |
CR | 5 | 2 | 7 | |
VGPR | 5 | 9 | 14 | |
PR | 7 | 6 | 13 | |
SD | 0 | 2 | 2 |
Factors | Univariate | Multivariate | ||
---|---|---|---|---|
HR (95% CI) | p | HR (95% CI) | p | |
Age (≥65 yrs) | 1.160 (0.467–2.880) | 0.75 | - | - |
Gender (Male) | 2.130 (1.036–4.381) | 0.04 | 1.401 (0.668–2.936) | 0.37 |
ISS (stage III) | 1.636 (0.811–3.299) | 0.17 | - | - |
Induction regimen (novel agent-based) | 1.019 (0.523–1.986) | 0.96 | - | - |
Response after ASCT (non-CR) | 4.312 (2.000–9.295) | 0.00019 | 4.284 (1.868–9.826) | 0.00059 |
Ig recovery (not all) | 2.533 (1.261–5.087) | 0.009 | 2.804 (1.334–5.896) | 0.0065 |
Factors | Univariate | Multivariate | ||
---|---|---|---|---|
HR (95% CI) | p | HR (95% CI) | p | |
Age (≥65 yrs) | 0.354 (0.0466–2.684) | 0.31 | - | - |
Gender (Male) | 1.409 (0.541–3.668) | 0.48 | - | - |
ISS (stage III) | 1.231 (0.454–3.340) | 0.68 | - | - |
Induction regimen (novel agent-based) | 0.358 (0.115–1.114) | 0.076 | - | - |
Response after ASCT (non-CR) | 7.595 (1.727–33.4) | 0.0073 | 8.245 (1.528–44.47) | 0.014 |
Ig recovery (not all) | 29.46 (3.815–227.6) | 0.0012 | 36.55 (3.942–338.8) | 0.0015 |
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Ozaki, S.; Harada, T.; Yagi, H.; Sekimoto, E.; Shibata, H.; Shigekiyo, T.; Fujii, S.; Nakamura, S.; Miki, H.; Kagawa, K.; et al. Polyclonal Immunoglobulin Recovery after Autologous Stem Cell Transplantation Is an Independent Prognostic Factor for Survival Outcome in Patients with Multiple Myeloma. Cancers 2020, 12, 12. https://doi.org/10.3390/cancers12010012
Ozaki S, Harada T, Yagi H, Sekimoto E, Shibata H, Shigekiyo T, Fujii S, Nakamura S, Miki H, Kagawa K, et al. Polyclonal Immunoglobulin Recovery after Autologous Stem Cell Transplantation Is an Independent Prognostic Factor for Survival Outcome in Patients with Multiple Myeloma. Cancers. 2020; 12(1):12. https://doi.org/10.3390/cancers12010012
Chicago/Turabian StyleOzaki, Shuji, Takeshi Harada, Hikaru Yagi, Etsuko Sekimoto, Hironobu Shibata, Toshio Shigekiyo, Shiro Fujii, Shingen Nakamura, Hirokazu Miki, Kumiko Kagawa, and et al. 2020. "Polyclonal Immunoglobulin Recovery after Autologous Stem Cell Transplantation Is an Independent Prognostic Factor for Survival Outcome in Patients with Multiple Myeloma" Cancers 12, no. 1: 12. https://doi.org/10.3390/cancers12010012