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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
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Drayson, M., Begum, G., Basu, S., Makkuni, S., Dunn, Janet A., Barth, N. and Child, J. A. (2006) 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. Blood, 108 (6). pp. 2013-2019. doi:10.1182/blood-2006-03-008953 ISSN 0006-4971.
An open access version can be found in:
Official URL: http://www.bloodjournal.org/content/108/6/2013
Abstract
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 λ than for κ 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. © 2006 by The American Society of Hematology.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Blood | ||||||
Publisher: | American Society of Hematology | ||||||
ISSN: | 0006-4971 | ||||||
Official Date: | 5 September 2006 | ||||||
Dates: |
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Volume: | 108 | ||||||
Number: | 6 | ||||||
Page Range: | pp. 2013-2019 | ||||||
DOI: | 10.1182/blood-2006-03-008953 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||
Open Access Version: |
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