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

作者：Juan José Lahuerta, Joaquín Martínez‐López, Javier de la Serna, Joan Bladé, Carlos Grande, Adrián Macías Alegre, Lourdes Vázquez, José García‐Laraña, Ana Sureda, Javier de la Rubia, Eulogio Conde, Rafael Martínez, Katy Perez‐Equiza, Jose Maria Moraleda, Ángel León, Juan Besalduch, Rafael Cabrera, José D. González‐San Miguel, Alfonso Javier Rodriguez-Morales, Juan Carlos García‐Ruiz, Joaquín Diaz‐Mediavilla, Jesús F. San Miguel, for the G ethand P ETHEMA G roups · 发表于：British Journal of Haematology · 年份：2000 · DOI：10.1046/j.1365-2141.2000.02012.x · 被引用次数：107 · 研究领域：Multiple Myeloma Research and Treatments、Cancer Treatment and Pharmacology、Amyloidosis: Diagnosis, Treatment, Outcomes

We have retrospectively analysed 344 multiple myeloma (MM) patients (202 de novo patients) treated in a non-uniform way in whom high-dose therapy and autologous stem cell transplantation (ASCT) response was simultaneously measured by both electrophoresis (EP) and immunofixation (IF). Patients in complete remission (CR) by EP were further subclassified as CR1 when IF was negative and CR2 when it remained positive. Partial responders (PR) were also subclassified as PR1 (very good PR, > 90% reduction in M-component) or PR2 (50-90% reduction). CR1 patients showed a significantly better event-free survival (EFS) [35% at 5 years, 95% confidence interval (CI) 17-53, median 46 months] and overall survival (OS) (72% at 5 years, CI 57-86, median not reached) compared with any other response group (univariate comparison P < 0.00000 to P = 0. 004). In contrast, comparison of CR2 with PR1 and with PR2 did not define different prognostic subgroups (median EFS 30, 30 and 26 months respectively, P = 0.6; median survival 56, 44 and 42 months respectively, P = 0.5). The non-responding patients had the worst outcome (5-year OS 8%, median 7 months). Multivariate analysis confirmed both the absence of differences among CR2, PR1 and PR2 and the highly discriminatory prognostic capacity of a three-category classification: (i) CR1 (ii) CR2 + PR1 + PR2, and (iii) non-response (EFS P < 0.00000; OS P < 0.00000; both Cox models P < 0.00000). In the logistic regression analysis, the factors significantly...