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Secondary monoclonal gammopathy of undetermined significance after allogeneic stem cell transplantation in multiple myeloma.
Schmitz, Marian F; Otten, Henny G; Franssen, Laurens E; van Dorp, Suzanne; Strooisma, Theo; Lokhorst, Henk M; van de Donk, Niels W C J.
Afiliação
  • Schmitz MF; Department of Hematology, University Medical Center Utrecht;
  • Otten HG; Laboratory for Translational Immunology, University Medical Center Utrecht;
  • Franssen LE; Department of Hematology, University Medical Center Utrecht; Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands.
  • van Dorp S; Department of Hematology, University Medical Center Utrecht;
  • Strooisma T; Laboratory for Translational Immunology, University Medical Center Utrecht;
  • Lokhorst HM; Department of Hematology, University Medical Center Utrecht; Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands.
  • van de Donk NW; Department of Hematology, University Medical Center Utrecht; Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands n.vandedonk@vumc.nl.
Haematologica ; 99(12): 1846-53, 2014 Dec.
Article em En | MEDLINE | ID: mdl-25193963
In the course of multiple myeloma, patients may develop a M-protein band different from the original: secondary monoclonal gammopathy of undetermined significance. In this retrospective single center analysis, we describe the occurrence and clinical relevance of secondary monoclonal gammopathy of undetermined significance after allogeneic stem cell transplantation (post-transplant monoclonal gammopathy of undetermined significance). A total of 138 patients who had undergone 139 allogeneic stem cell transplantations (39.6% in the upfront setting and 60.4% for relapsed multiple myeloma) were included in the study. Sixty-seven (48.2%) patients developed secondary monoclonal gammopathy of undetermined significance, after a median latency of 6.9 months. Secondary monoclonal gammopathy of undetermined significance occurred more often in patients who achieved at least very good partial response after allogeneic stem cell transplantation, compared to partial response or less (54.8% vs. 26.5%; P=0.005). The incidence was also higher in the upfront setting as compared to relapsed disease, or with a sibling donor compared to matched unrelated donor, but less often after T-cell depletion. Importantly, development of post-transplant monoclonal gammopathy of undetermined significance as a time-dependent variable independently predicted for superior progression-free and overall survival (median progression-free survival 37.5 vs. 6.3 months, P<0.001; median overall survival 115.3 vs. 31.0 months, P=0.004). Clinicians should be aware of the benign nature of this phenomenon, and secondary monoclonal gammopathy of undetermined significance should not be confused with relapse or progression of disease. (Trial registered with trialregister.nl; HOVON 108: NTR 2958.).
Assuntos

Texto completo: 1 Coleções: 01-internacional Temas: Geral / Tipos_de_cancer / Outros_tipos Base de dados: MEDLINE Assunto principal: Gamopatia Monoclonal de Significância Indeterminada / Transplante de Células-Tronco Hematopoéticas / Mieloma Múltiplo / Recidiva Local de Neoplasia Tipo de estudo: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Haematologica Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Temas: Geral / Tipos_de_cancer / Outros_tipos Base de dados: MEDLINE Assunto principal: Gamopatia Monoclonal de Significância Indeterminada / Transplante de Células-Tronco Hematopoéticas / Mieloma Múltiplo / Recidiva Local de Neoplasia Tipo de estudo: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Haematologica Ano de publicação: 2014 Tipo de documento: Article