Early Normalization of Free Light Chains Predicts Better Outcomes in Patients with Multiple Myeloma

  • Rony Benson Department of Medical Oncology, Regional Cancer Centre, Thiruvananthapuram 695011, India
  • Sreejith G Nair Mail Department of Medical Oncology, Regional Cancer Centre, Thiruvananthapuram 695011, India
  • Geetha Narayanan Department of Medical Oncology, Regional Cancer Centre, Thiruvananthapuram 695011, India
Keywords:
Light chain response; Multiple myeloma; Prognostic marker

Abstract

in patients with multiple myeloma [MM]. This prospective study is aimed at evaluating whether early light chain response can predict response to treatment in patients with MM.

Materials and Methods: Thirty six patients with a diagnosis of MM and with an abnormal to normal light chain ratio of > 10 were included in this study.

Results: The median age at presentation was 56 years. Fourteen patients had lambda light chain disease, whereas 22 patients had kappa light chain disease. Twenty-four patients [66.6%] had reduction of abnormal to normal light chain ratio to < 10 after 2 cycles, of whom 15 [62.5%] achieved a CR or VGPR after 6 cycles. Among 12 patients who did not have reduction of abnormal to normal light chain ratio to < 10, only 1 patient achieved CR while 11 patients [91.6%] achieved a PR or less[Fishers exact p=0.004]. Median follow-up was 13 months. Median progression-free survival for the entire cohort was 15 months. One-year Progression-Free Survival was 77% vs 57.1%, [p= 0.008], respectively for patients with early normalization and those who did not show early normalization.

Conclusion: Early light chain response after 2 cycles of chemotherapy is a good predictor for treatment response in patients with MM treated with bortezomib based chemotherapy. Treatment intensification based on early light chain response merits further evaluation in a prospective trial

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Published
2020-10-07
How to Cite
1.
Benson R, Nair S, Narayanan G. Early Normalization of Free Light Chains Predicts Better Outcomes in Patients with Multiple Myeloma. Int J Hematol Oncol Stem Cell Res. 14(4):226-231.
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Original Article(s)