Immunoparesis in newly diagnosed Multiple Myeloma patients: Effects on overall survival and progression free survival in the Danish population

Rasmus Sørrig, Tobias W Klausen, Morten Salomo, Annette J Vangsted, Ulf Christian Frølund, Kristian T Andersen, Anja Klostergaard, Carsten Helleberg, Robert S Pedersen, Per T Pedersen, Sissel Helm-Petersen, Elena Manuela Teodorescu, Birgitte Preiss, Niels Abildgaard, Peter Gimsing, Danish Myeloma Study Group, Asta Svirskaite (Member of study group), Elena Manuela Teodorescu (Member of study group), Hans Erik Johnsen (Member of study group), Henrik Gregersen (Member of study group)Inger Lise Gade (Member of study group), Julie Støve Bødker (Member of study group)

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35 Citations (Scopus)

Abstract

Immunoparesis (hypogammaglobulinemia) is associated to an unfavorable prognosis in newly diagnosed Multiple myeloma (MM) patients. However, this finding has not been validated in an unselected population-based cohort. We analyzed 2558 newly diagnosed MM patients in the Danish Multiple Myeloma Registry representing the entire MM population in Denmark from 2005-2013. Two-thousand two hundred and fifty three patients (90%) presented with reduction below lower normal levels of at least one uninvolved immunoglobulin. Using multivariable Cox regression we found that high age, high ISS score, high LDH and IgA MM were associated to both shorter overall survival and progression free survival. Furthermore, bone marrow plasma cell % was associated to short progression free survival. Immunoparesis had no independent significant effect on OS (HR 0.9 (95%CI: 0.7;1.0; p = 0.12)). Likewise, the number of suppressed immunoglobulins or the relative degree of suppressed uninvolved immunoglobulins from lower normal level (quantitative immunoparesis) was not associated to OS in the multivariable analysis. However, quantitative immunoparesis with at least 25% reduction (from lower normal level) of uninvolved immunoglobulins was associated to shorter PFS for the entire population. The impact of quantitative immunoparesis on PFS was present irrespective of calendar periods 2005-2008 and 2009-2013. Our population-based study does not confirm that immunoparesis at diagnosis is an independent prognostic factor regarding OS. However, quantitative immunoparesis is associated to a shorter PFS.

Original languageEnglish
Article numbere0188988
JournalPLOS ONE
Volume12
Issue number12
Number of pages15
ISSN1932-6203
DOIs
Publication statusPublished - 2017

Keywords

  • Journal Article

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