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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 (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 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted March 9, 2006 Accepted May 9, 2006 The effect of paraprotein heavy and light chain type 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 Division of Immunity and Infection, University of Birmingham Cancer Research UK Clinical Trials Unit, University of Birmingham Department of Haematology, University of Birmingham Clinical Trials Research Unit, University of Leeds * Corresponding author; email: m.t.drayson{at}bham.ac.uk. Investigating 2592 patients enrolled in multicentre myeloma trials we found light chain only (LCO) patients had the worst median survival of 1.9 years compared to 2.3 and 2.5 years in patients with IgA and IgG paraproteins (p<0.0001). However IgA/IgG patients with similar levels of LC excretion as LCO patients had similarly poor survival which is attributable to renal failure. This results 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 lambda than kappa types but there was no difference in survival between the two LC types when stratified for level of LC excretion. This highlights that care of renal function is vital to improving survival of any patient with LC excretion. LCO patients were younger (p=0.0002), had worse performance status (p=0.0002) and more lytic lesions (p<0.0001) perhaps reflecting late and missed diagnosis in younger and older LCO patients respectively. There was no difference in presentation characteristics, response, or survival from progression of IgA and IgG patients. The worse survival of IgA patients was due to a shorter progression free survival (median 1.2 versus 1.6 years p<0.0001) which is of importance to 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]

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