SEARCH:   Advanced

Blood, 15 September 2006, Vol. 108, No. 6, pp. 2013-2019. Prepublished online as a Blood First Edition Paper on May 25, 2006; DOI 10.1182/blood-2006-03-008953. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-03-008953v1 108/6/2013    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Drayson, M. Articles by Child, J. A. Search for Related Content PubMed PubMed Citation Articles by Drayson, M. Articles by Child, J. A. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  NEOPLASIA Effects of paraprotein heavy and light chain types and free light chain load on survival in myeloma: an analysis of patients receiving conventional-dose chemotherapy in Medical Research Council UK multiple myeloma trials Mark Drayson, Gulnaz Begum, Supratik Basu, Sudhaker Makkuni, Janet Dunn, Nicola Barth, and J. Anthony Child From the Division of Immunity and Infection, the Cancer Research UK Clinical Trials Unit, and the Department of Haematology, Royal Wolverhampton NHS Trust and Division of Cancer Studies, University of Birmingham, Birmingham, United Kingdom; and the Clinical Trials Research Unit, University of Leeds, Leeds, United Kingdom. While investigating 2592 patients enrolled in multicenter myeloma trials, we found light chain–only (LCO) patients had worse median survival times (1.9 years) than patients with IgA and IgG paraproteins (2.3 and 2.5 years, respectively) (P < .001). However, IgA and IgG patients with levels of LC excretion similar to those of LCO patients also had poor survival times because of renal failure, resulting in worse survival during induction therapy and at relapse with no difference in progression-free survival between LCO and IgG patients. LC excretion was higher for than for types, but there was no difference in survival between the 2 LC types when stratified for level of LC excretion, indicating that care of renal function is vital to improving the survival of any patient with LC excretion. LCO patients were younger (P = .001), had worse performance status (P = .001), and had more lytic lesions (P < .001), perhaps reflecting late and missed diagnoses in younger and older LCO patients, respectively. No differences were observed between IgA and IgG patients in presentation characteristics, response, or survival from disease progression. The worse survival of IgA patients was attributed to shorter progression-free survival (median, 1.2 vs 1.6 years; P < .001), which is important for maintenance therapy. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: A. Dispenzieri, L. Zhang, J. A. Katzmann, M. Snyder, E. Blood, R. DeGoey, K. Henderson, R. A. Kyle, M. M. Oken, A. R. Bradwell, et al. Appraisal of immunoglobulin free light chain as a marker of response Blood, May 15, 2008; 111(10): 4908 - 4915. [Abstract] [Full Text] [PDF]

	Copyright © 2006 by American Society of Hematology         Online ISSN: 1528-0020