Severe and continuous immunoparesis during induction or maintenance therapy in nontransplant patients with multiple myeloma is a sign of poor prognosis

ABSTRACT

Objective

Multiple myeloma (MM) varies in clinical behavior, response to treatment and prognosis due to the heterogeneity of the disease. Data on the association between the immunoparesis status during treatment and prognosis in nontransplant MM patients are limited.

Methods

In a retrospective analysis of 142 patients with MM, we examined the relationship between immunoparesis status and prognosis during treatment. All patients received novel agent-based therapy and did not undergo autologous stem cell transplantation. One, two, or three uninvolved immunoglobulins (Igs) below the lowest thresholds of normalcy were used to identify immunoparesis.

Results

Patients with a greater degree of immunoparesis during treatment had shorter progression-free survival (PFS) and overall survival (OS). A total of 46.5% of the patients had severe and continuous immunoparesis (at least two uninvolved Igs suppressed continuously during treatment), representing a worse prognosis than those with complete or partial normalization of Igs during treatment. Among patients who achieved at least complete remission, PFS was poor in patients with severe and continuous immunoparesis. Furthermore, severe and continuous immunoparesis during treatment was a poor prognostic factor for PFS and OS according to multivariate analyses.

Conclusion

The degree of immunoparesis during treatment is a follow-up indicator for survival in nontransplant myeloma patients, and severe and continuous immunoparesis in nontransplant myeloma patients might be a sign of poor prognosis.

KEYWORDS:

• severe and continuous immunoparesis
• multiple myeloma
• treatment
• survival
• response

Acknowledgements

We are particularly grateful to all the people who have given us help with our article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval and consent to participate

The study was conducted in accordance with the Declaration of Helsinki (as was revised in 2013). The study was approved by the Ethics Committee of The Affiliated People's Hospital of Ningbo University. The requirement for informed consent was waived by the Ethics Committee due to the retrospective nature of the study.

Data Availability statement

The relevant supporting data are available from the author upon request.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China [grant number 81872433] and the Municipal Natural Science Foundation of Ningbo [grant number 2021J018].