当前位置: X-MOL 学术Amyloid › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Survival impact of achieving minimal residual negativity by multi-parametric flow cytometry in AL amyloidosis.
Amyloid ( IF 5.5 ) Pub Date : 2019-09-23 , DOI: 10.1080/13506129.2019.1666709
Eli Muchtar 1 , Angela Dispenzieri 1 , Dragan Jevremovic 2 , David Dingli 1 , Francis K Buadi 1 , Martha Q Lacy 1 , Wilson Gonsalves 1 , Rahma Warsame 1 , Taxiarchis V Kourelis 1 , Suzanne R Hayman 1 , Prashant Kapoor 1 , Nelson Leung 1, 3 , Stephen Russell 1 , John A Lust 1 , Yi Lin 1 , Ronald S Go 1 , Steven Zeldenrust 1 , Robert A Kyle 1 , S Vincent Rajkumar 1 , Shaji K Kumar 1 , Morie A Gertz 1
Affiliation  

Response assessment in light chain (AL) amyloidosis is challenging given the low level of circulating free light chains usually seen. Multi-parametric flow cytometry (MFC) from a marrow aspirate was demonstrated to retain a prognostic significance in several recent studies. In this work, 82 AL patients who had MFC study at end of therapy were analysed based on whether clonal plasma cells were detected or not. Among patients who achieved deep response (i.e. very good partial response or complete response) to first-line therapy, lack of clonal marrow plasma cells as measured by MFC was associated with improved progression-free survival (PFS) compared to patients with residual clonal plasma cells (3-year PFS 88% vs. 46%, p = .003), particularly among patients who achieved a complete response (3-year PFS 100% vs. 33%, p = .001). Absence of clonal plasma cells by MFC compared with patients with detectable clonal plasma cells among deep responders was associated with lower level of involved light chain (involved free light chain (iFLC), median 1.1 vs. 1.7 mg/dL; p = .02) and higher frequency of renal response (100% vs. 68%; p = .005). Further studies are needed to determine if MFC should be incorporated into response criteria in AL amyloidosis.

中文翻译:

通过多参数流式细胞术在AL淀粉样变性中获得最小残留负值的生存影响。

鉴于通常观察到的循环游离轻链水平低,轻链(AL)淀粉样变性的反应评估具有挑战性。在最近的几项研究中,来自骨髓穿刺物的多参数流式细胞术(MFC)被证明具有预后意义。在这项工作中,根据是否检测到克隆性浆细胞,分析了82名在治疗结束后接受MFC研究的AL患者。在对一线治疗产生深刻反应(即非常好的部分反应或完全反应)的患者中,与残留的血浆残留患者相比,通过MFC测量的缺乏骨髓浆细胞与无进展生存期(PFS)改善相关细胞(3年PFS分别为88%和46%,p = .003),尤其是那些获得完全缓解的患者(3年PFS分别为100%和33%,p = 0.001)。与深度反应者中可检测到的克隆性浆细胞相比,MFC缺乏克隆性浆细胞的患者所涉及的轻链水平较低(涉及的游离轻链(iFLC),中位数为1.1到1.7 mg / dL; p = .02)和较高的肾脏反应频率(100%比68%; p = .005)。需要进一步研究以确定是否应将MFC纳入AL淀粉样变性的反应标准中。
更新日期:2020-04-20
down
wechat
bug