Radocha Jakub, Pour Luděk, Pika Tomáš, Maisnar Vladimír, Špička Ivan, Gregora Evžen, Krejčí Marta, Minařík Jiří, Machálková Kateřina, Straub Jan, Pavlíček Petr, Hájek Roman, Žák Pavel
4th Department of Medicine - Hematology, Charles University Hospital and Faculty of Medicine Hradec, Králové, Czech Republic.
Department of Internal Medicine-Hematooncology, University Hospital Brno, Brno, Czech Republic.
Eur J Haematol. 2016 Feb;96(2):119-27. doi: 10.1111/ejh.12556. Epub 2015 Apr 21.
The normalization of free light chain ratio (FLCr) has been introduced as a marker of stringent complete remission (CR) of multiple myeloma (MM). There is currently a lack of literature assessing the role of FLCr on MM disease progression and remission status.
A multicentered retrospective review of 125 patients with MM in CR and various FLCr values was completed. Parameters of interest included patient demographics, FLCr values, complete remission (CR)/relapse status, and time to progression (TTP). The FLCr values were recorded to provide time-dependent findings on the role of FLCr on progression-free survival and overall survival (OS).
The mean follow-up time of 125 patients from five hospitals in the Czech Republic was 31 months. A total of 47.2% of patients relapsed (54 of 125) during the follow-up period. The median TTP of patients with normal FLCr (n = 66) was 54.4 and 40.2 months for patients with abnormal FLCr (n = 59) (P = 0.217). None of the patients reached median overall survival regardless of FLCr values (P = 0.821). In the subgroup of newly diagnosed patients after upfront autologous stem cell transplantation (ASCT), there were 55.6% of patients (35 of 63) with normal FLCr and 44.4% (28 of 64) with abnormal FLCr. A total of 34.9% of patients (22 of 63) relapsed in this subgroup. Within the abnormal FLCr patients, a median TTP was 56.3 months, but no median TTP was reached among the normal FLCr patients (P = 0.746). Median OS in patients with normal (nFLCr) and abnormal FLCr (aFLCr) was not reached (P = 0.787).
We did not observe any benefit from FLCr normalization in CR in myeloma patients in terms of progression-free survival or overall survival.
游离轻链比值（FLCr）的正常化已被引入作为多发性骨髓瘤（MM）严格完全缓解（CR）的一个标志物。目前缺乏评估FLCr在MM疾病进展和缓解状态中作用的文献。
对125例处于CR且FLCr值各异的MM患者进行了多中心回顾性研究。感兴趣的参数包括患者人口统计学特征、FLCr值、完全缓解（CR）/复发状态以及疾病进展时间（TTP）。记录FLCr值以提供关于FLCr在无进展生存期和总生存期（OS）方面作用的时间依赖性研究结果。
来自捷克共和国五家医院的125例患者的平均随访时间为31个月。在随访期间，共有47.2%的患者复发（125例中的54例）。FLCr正常的患者（n = 66）的中位TTP为54.4个月，FLCr异常的患者（n = 59）为40.2个月（P = 0.217）。无论FLCr值如何，均无患者达到中位总生存期（P = 0.821）。在初次自体干细胞移植（ASCT）后新诊断患者的亚组中，FLCr正常的患者占55.6%（63例中的35例），FLCr异常的患者占44.4%（64例中的28例）。该亚组中共有34.9%的患者（63例中的22例）复发。在FLCr异常的患者中，中位TTP为56.3个月，但FLCr正常的患者未达到中位TTP（P = 0.746）。FLCr正常（nFLCr）和异常（aFLCr）的患者均未达到中位总生存期（P = 0.787）。
就无进展生存期或总生存期而言，我们未观察到骨髓瘤患者CR时FLCr正常化有任何益处。
