Polyclonal serum IgM level identifies a subgroup of multiple myeloma patients with low-risk clinicobiological features and superior survival.

Abstract

Normal plasma cells (PCs) are either undetectable or outnumbered by the myelomatous PC compartment in bone marrow of multiple myeloma (MM). However, residual normal PCs have been detected in a minority of symptomatic MM patients with superior survival. The number of normal PCs is also an important factor to identify monoclonal gammopathy of undetermined significance (MGUS)-like MM. We speculate that the polyclonal serum IgM level in non-IgM myelomas may reflect the number of residual normal PCs. Here we investigated the prognostic relevance of polyclonal serum IgM level in a series of 485 newly diagnosed symptomatic MM (NDMM) patients. Our results showed that symptomatic MM patients with polyclonal IgM more than 0.5g/L displayed a favorable baseline clinical feature, together with a significantly lower frequency of high-risk cytogenetic abnormalities. This group of patients had a significantly prolonged progression-free survival (PFS) and overall survival (OS) regardless of thalidomide or bortezomib therapy. Furthermore, the superior outcome was independent of the depth of response. Our findings suggest that polyclonal IgM level is capable of identifying a group of symptomatic MM patients with distinct clinicobiological characteristics and favorable survival, similar with MGUS-like MM.

• Authors: Gang An, Huijun Wang, Xiaoqi Qin, Lihui Shi, Yan Xu, Shuhui Deng, Weiwei Sui, Guoqing Zhu, Hongjing Yao, Shuhua Yi, Yu Qin, Fei Li, Mu Hao, Kun Ru, Junyuan Qi, Tao Cheng, Jianxiang Wang, Hong Chang, Lugui Qiu
• Journal: Leukemia research (Leuk Res) Vol. 38 Issue 6 Pg. 666-72 (Jun 2014) ISSN: 1873-5835 [Electronic] England
• PMID: 24746293 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ltd. All rights reserved.

Chemical References

• Antigens, CD19
• Boronic Acids
• Immunoglobulin M
• Pyrazines
• Bortezomib
• Proto-Oncogene Proteins c-kit

Topics

• Antigens, CD19 (blood)
• Boronic Acids (therapeutic use)
• Bortezomib
• Disease-Free Survival
• Female
• Humans
• Immunoglobulin M (blood)
• Male
• Middle Aged
• Multiple Myeloma (immunology, mortality, pathology)
• Proto-Oncogene Proteins c-kit (blood)
• Pyrazines (therapeutic use)