尾崎, 修治 Tokushima Prefectural Central Hospital
原田, 武志 Tokushima University 徳島大学 教育研究者総覧
Yagi, Hikaru Tokushima Prefectural Central Hospital
Sekimoto, Etsuko Tokushima Prefectural Central Hospital
Shibata, Hironobu Tokushima Prefectural Central Hospital
Shigekiyo, Toshio Tokushima Prefectural Central Hospital
藤井, 志朗 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
中村, 信元 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
三木, 浩和 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
賀川, 久美子 Tokushima University KAKEN研究者をさがす
安倍, 正博 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
autologous stem cell transplantation
We retrospectively analyzed multiple myeloma (MM) patients who underwent autologous stem cell transplantation (ASCT) without maintenance therapy to assess the impact of recovery of normal immunoglobulin (Ig) on clinical outcomes. The recovery of polyclonal Ig was defined as normalization of all values of serum IgG, IgA, and IgM 1 year after ASCT. Among 50 patients, 26 patients showed polyclonal Ig recovery; 14 patients were in ≥complete response (CR) and 12 remained in non-CR after ASCT. The patients with Ig recovery exhibited a significantly better progression-free survival (PFS, median, 46.8 vs. 26.7 months, p = 0.0071) and overall survival (OS, median, not reached vs. 65.3 months, p < 0.00001) compared with those without Ig recovery. The survival benefits of Ig recovery were similarly observed in ≥CR patients (median OS, not reached vs. 80.5 months, p = 0.061) and non-CR patients (median OS, not reached vs. 53.2 months, p = 0.00016). Multivariate analysis revealed that non-CR and not all Ig recovery were independent prognostic factors for PFS (HR, 4.284, 95%CI (1.868–9.826), p = 0.00059; and HR, 2.804, 95%CI (1.334–5.896), p = 0.0065, respectively) and also for OS (HR, 8.245, 95%CI (1.528–44.47), p = 0.014; and HR, 36.55, 95%CI (3.942–338.8), p = 0.0015, respectively). Therefore, in addition to the depth of response, the recovery of polyclonal Ig after ASCT is a useful indicator especially for long-term outcome and might be considered to prevent overtreatment with maintenance therapy in transplanted patients with MM.
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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