Characterisation of immunoparesis in newly diagnosed myeloma and its impact on progression-free and overall survival in both old and recent myeloma trials

• DOI: 10.1038/s41375-018-0163-4
• Publication Date: 2018-06-20T08:51:04Z
• Authors: Jennifer L. J. He...; John P. Campbell; Gulnaz Iqbal; David Cairns; Alex Richter; J. Anthony Child; Walter Gregory; Graham Jackson; Martin Kaiser; Roger Owen; Faith Davies; Gareth Morgan; Janet Dunn; Mark T. Drayson
• Keywords: Progression-free survival; Immunosuppression

We measured immunosuppression at myeloma diagnosis and assessed the impact on survival in 5826 UK trial patients. Polyclonal immunoglobulin levels were below normal 85% of patients above only 0.4% cases for IgA, 0.2% IgM no IgG. Immunoparesis had a greater recent trials: median overall (OS) was up to 3 years longer without immunoparesis compared old trials, less than 1 year longer. Median progression-free (PFS) 39%, 36% 57% with IgG, IgA levels, respectively. The depth suppression, but not IgG or prognostic survival: most severely suppressed tertile OS 0.9 shorter those top tertile, 2.6 (p = .007). degree suppression polyclonal associated worse PFS .0002). Infection does appear be main mechanism through which affects survival. hypothesise that impacts combination being more aggressive disease reduced immune surveillance against relapse.