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000177028 1001_ $$aKlein, Eva-Maria$$b0
000177028 245__ $$aPrognostic Impact of Serum Free Light Chain Ratio Normalization in Patients with Multiple Myeloma Treated within the GMMG-MM5 Trial.
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000177028 520__ $$aWe investigated the prognostic impact of time-dependent serum free light chain ratio (FLCr) normalization in 590 patients with secretory multiple myeloma (MM) during first-line treatment within the German-Speaking Myeloma Multicenter Group MM5 trial. Serum free light chains (sFLC) were assessed by the Freelite test at baseline, after induction, mobilization, autologous blood stem cell transplantation, consolidation and every three months during maintenance or follow up within two years after the start of maintenance. The proportion of patients with a normal or normalized FLCr increased from 3.6% at baseline to 23.2% after induction and 64.7% after consolidation. The achievement of FLCr normalization at any one time before the start of maintenance was associated with significantly prolonged progression-free survival (PFS) (p < 0.01, hazard ratio (HR) = 0.61, 95% confidence interval (95% CI) = 0.47-0.79) and overall survival (OS) (p = 0.02, HR = 0.67, 95% CI = 0.48-0.93) in multivariable time-dependent Cox regression analyses. Furthermore, reaching immune reconstitution, defined as the normalization of uninvolved immunoglobulins, before maintenance was associated with superior PFS (p = 0.04, HR = 0.77, 95% CI = 0.60-0.99) and OS (p = 0.01, HR = 0.59, 95% CI = 0.41-0.86). We conclude that FLCr normalization during therapy is an important favorable prognostic factor in MM. Therefore, we recommend serial measurements of sFLC during therapy until achieving FLCr normalization, even in patients with secretory MM.
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000177028 650_7 $$2Other$$aimmune reconstitution
000177028 650_7 $$2Other$$amultiple myeloma
000177028 650_7 $$2Other$$aprognostic factors
000177028 650_7 $$2Other$$aserum free light chain ratio normalization
000177028 650_7 $$2Other$$atime-dependent analysis
000177028 7001_ $$0P:(DE-He78)2ef631585610340ff425c9c31fcabd03$$aTichy, Diana$$b1$$udkfz
000177028 7001_ $$aSalwender, Hans J$$b2
000177028 7001_ $$00000-0002-6226-1252$$aMai, Elias K$$b3
000177028 7001_ $$aDuerig, Jan$$b4
000177028 7001_ $$aWeisel, Katja C$$b5
000177028 7001_ $$0P:(DE-He78)e15dfa1260625c69d6690a197392a994$$aBenner, Axel$$b6$$udkfz
000177028 7001_ $$aBertsch, Uta$$b7
000177028 7001_ $$aAkhavanpoor, Mabast$$b8
000177028 7001_ $$aBesemer, Britta$$b9
000177028 7001_ $$aMunder, Markus$$b10
000177028 7001_ $$aLindemann, Hans-Walter$$b11
000177028 7001_ $$aHose, Dirk$$b12
000177028 7001_ $$00000-0002-2771-712X$$aSeckinger, Anja$$b13
000177028 7001_ $$aLuntz, Steffen$$b14
000177028 7001_ $$aJauch, Anna$$b15
000177028 7001_ $$aElmaagacli, Ahmet$$b16
000177028 7001_ $$00000-0002-7785-2565$$aFuhrmann, Stephan$$b17
000177028 7001_ $$aBrossart, Peter$$b18
000177028 7001_ $$aGoerner, Martin$$b19
000177028 7001_ $$aBernhard, Helga$$b20
000177028 7001_ $$aRaab, Marc S$$b21
000177028 7001_ $$aBlau, Igor W$$b22
000177028 7001_ $$aHaenel, Mathias$$b23
000177028 7001_ $$aScheid, Christof$$b24
000177028 7001_ $$aGoldschmidt, Hartmut$$b25
000177028 7001_ $$aOn Behalf Of The German-Speaking Myeloma Multicenter Group Gmmg$$b26
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