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Markovic U, Romano A, Bellofiore C, Condorelli A, Garibaldi B, Bulla A, Duminuco A, Del Fabro V, Di Raimondo F, Conticello C. Role of Serum Free Light Chain Assay in Relapsed/Refractory Multiple Myeloma. A Real-Life Unicentric Retrospective Study. Cancers (Basel) 2021; 13:cancers13236017. [PMID: 34885127 PMCID: PMC8656731 DOI: 10.3390/cancers13236017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/24/2021] [Accepted: 11/27/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In the era of novel drugs a growing number of multiple myeloma (MM) patients are treated until disease progression. Serum free light chain (sFLC) assay is recommended for disease monitoring in oligo-secretory and micromolecular MM. METHODS In this real-life survey, a total of 130 relapsed/refractory MM patients treated at our center with at least three lines were investigated as a retrospective cohort. RESULTS The median age at diagnosis was 64 years and more than half of patients were male. A total of 24 patients (18%) had oligo-secretory/micromolecular disease at diagnosis. More than 20% of 106 normo-secretory patients had oligo-secretory/micromolecular escape. In order to evaluate potential role of sFLC assay before ("pre") and after ("post") every treatment line, involved serum free light chain values (iFLC) less than 138 mg/mL and serum free light chain ratios (FLCr) <25 were identified by using ROC curve analysis. The analysis of the entire cohort throughout four treatment lines demonstrated a statistically significant negative impact on progression-free survival (PFS) for both involved pre-sFLC and its ratio (respectively p = 0.0086 and p = 0.0065). Furthermore, both post-iFLC and post-FLCr greater than the pre-established values had a negative impact on PFS of the study cohort; respectively, p = 0.014 and p = 0.0079. Odds ratio analysis evidenced that patients with both involved post-sFLC greater than 138 mg/mL and post-FLCr above 25 at disease relapse had a higher probability of having clinical relapse (respectively p = 0.026 and p = 0.006). CONCLUSIONS Alterations of sFLC values, namely iFLC and FLCr, both prior to treatment initiation and in the course of therapy at every treatment line, could be of aid in relapse evaluation and treatment outcome. We therefore suggest close periodical monitoring of sFLC assay, independently from secretory status.
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Affiliation(s)
- Uros Markovic
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95124 Catania, Italy; (A.R.); (C.B.); (A.C.); (B.G.); (A.B.); (A.D.); (V.D.F.); (F.D.R.); (C.C.)
- Oncohematology and BMT Unit, Mediterranean Institute of Oncology, 95029 Viagrande, Italy
- Correspondence:
| | - Alessandra Romano
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95124 Catania, Italy; (A.R.); (C.B.); (A.C.); (B.G.); (A.B.); (A.D.); (V.D.F.); (F.D.R.); (C.C.)
- Postgraduate School of Hematology, University of Catania, 95124 Catania, Italy
| | - Claudia Bellofiore
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95124 Catania, Italy; (A.R.); (C.B.); (A.C.); (B.G.); (A.B.); (A.D.); (V.D.F.); (F.D.R.); (C.C.)
- Postgraduate School of Hematology, University of Catania, 95124 Catania, Italy
| | - Annalisa Condorelli
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95124 Catania, Italy; (A.R.); (C.B.); (A.C.); (B.G.); (A.B.); (A.D.); (V.D.F.); (F.D.R.); (C.C.)
- Postgraduate School of Hematology, University of Catania, 95124 Catania, Italy
| | - Bruno Garibaldi
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95124 Catania, Italy; (A.R.); (C.B.); (A.C.); (B.G.); (A.B.); (A.D.); (V.D.F.); (F.D.R.); (C.C.)
- Postgraduate School of Hematology, University of Catania, 95124 Catania, Italy
| | - Anna Bulla
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95124 Catania, Italy; (A.R.); (C.B.); (A.C.); (B.G.); (A.B.); (A.D.); (V.D.F.); (F.D.R.); (C.C.)
| | - Andrea Duminuco
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95124 Catania, Italy; (A.R.); (C.B.); (A.C.); (B.G.); (A.B.); (A.D.); (V.D.F.); (F.D.R.); (C.C.)
- Postgraduate School of Hematology, University of Catania, 95124 Catania, Italy
| | - Vittorio Del Fabro
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95124 Catania, Italy; (A.R.); (C.B.); (A.C.); (B.G.); (A.B.); (A.D.); (V.D.F.); (F.D.R.); (C.C.)
| | - Francesco Di Raimondo
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95124 Catania, Italy; (A.R.); (C.B.); (A.C.); (B.G.); (A.B.); (A.D.); (V.D.F.); (F.D.R.); (C.C.)
- Postgraduate School of Hematology, University of Catania, 95124 Catania, Italy
| | - Concetta Conticello
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95124 Catania, Italy; (A.R.); (C.B.); (A.C.); (B.G.); (A.B.); (A.D.); (V.D.F.); (F.D.R.); (C.C.)
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