Remission status defined by immunofixation vs. electrophoresis after autologous transplantation has a major impact on the outcome of multiple myeloma patients

• DOI: 10.1046/j.1365-2141.2000.02012.x
• Publication Date: 2003-03-11T06:24:20Z
• Authors: Juan José Lahuerta; Joaquín Martinez‐...; Javier de la Serna; Joan Bladé; Carlos Grande; Adrián Alegre; Lourdes Vazquez; José García‐Laraña; Ana Sureda; Javier de la Rubia; Eulogio Conde; Rafael Martinez; Katy Perez‐Equiza; José M. Moraleda; Angel León; Juan Besalduch; Rafael Cabrera; José D. Gonzalez‐...; Alfonso Morales; Juan C. García‐Ruíz; Joaquín Diaz‐Medi...; Jesús San‐Miguel
• Keywords: Immunofixation; Univariate analysis; Autologous stem-cell transplantation

We have retrospectively analysed 344 multiple myeloma (MM) patients (202 de novo patients) treated in a non‐uniform way whom high‐dose therapy and autologous stem cell transplantation (ASCT) response was simultaneously measured by both electrophoresis (EP) immunofixation (IF). Patients complete remission (CR) EP were further subclassified as CR1 when IF negative CR2 it remained positive. Partial responders (PR) also PR1 (very good PR, > 90% reduction M‐component) or PR2 (50–90% reduction). showed significantly better event‐free survival (EFS) [35% at 5 years, 95% confidence interval (CI) 17–53, median 46 months] overall (OS) (72% CI 57–86, not reached) compared with any other group (univariate comparison P < 0·00000 to = 0·004). In contrast, of did define different prognostic subgroups (median EFS 30, 30 26 months respectively, 0·6; 56, 44 42 0·5). The non‐responding had the worst outcome (5‐year OS 8%, 7 months). Multivariate analysis confirmed absence differences among CR2, highly discriminatory capacity three‐category classification: (i) (ii) + PR2, (iii) non‐response (EFS 0·00000; Cox models 0·00000). logistic regression analysis, factors associated failure achieve use two more up‐front chemotherapy lines, status pre‐ASCT inclusion total body irradiation (TBI) preparative regimen. Tandem transplants agents (busulphan melphalan) regimen resulted higher level; none biological explored influenced possibility achieving CR1. These results confirm that, MM undergoing ASCT, identifies patient subset best prognosis; accordingly, therapeutic strategies should be specifically designed IF.