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MULTIPLE MYELOMA, GAMMOPATHIES

Sensitive quantitative IgD assay increases progression-free survival prediction accuracy in IgD plasma cell myeloma

Leukemia volume 37, pages 497–499 (2023)Cite this article

Subjects

IgD plasma cell myeloma (PCM) comprises less than 2 percent of PCMs [1,2,3,4]. Study from the Asia Myeloma Network (AMN) and others report a poorer prognosis compared with other PCM isotypes [5,6,7]. Accurate response assessment is important in monitoring therapy efficacy and estimating prognosis. Currently, the International Myeloma Working Group (IMWG) recommends quantitative IgD (qIgD) measurements to assess response whose value is unvalidated in large series [8]. Our aim was to compare accuracy of the IMWG response criteria for predicting progression-free survival (PFS) compared with prediction using data of serum IgD concentration determined on a SPA PLUS Specialist Protein Analyser (FreeliteTM®; The Binding Site Group Ltd, Birmingham, UK).

We interrogated data from 100 consecutive subjects with IgD PCM seen at Shanghai Changzheng Hospital September, 2013 to December, 2021. Ethical committee approvals were obtained and study protocol was approved by the Institutional Review Board of each institution. SAS 9.4 and R 3.5.1 were used for the statistical analysis. Baseline subject co-variates are displayed in Supplement Table 1. Median qIgD and serum M-component was 10.94 g/L (range, 0.11–16.8 g/L) and 4.3 g/L (range, 0–40 g/L) at diagnosis respectively. Sensitivity of the qIgD assay was significantly greater than the serum M-component in 37 subjects whose M-component concentrations were <10 g/L, with qIgD concentrations >10 g/L. Subjects receiving bortezomib/IMiD® triple therapy had better PFS compared with those receiving other regimens (Supplement Fig. 1A). Details of the induction treatment regimens are displayed in Supplement Table 2. Median PFS was longer in auto-transplant versus non-transplant recipients (26 months [95% Confidence Interval [CI], 22, 30 months] versus 13 months [10, 16 months]; P = 0.005; Supplement Fig. 1B).

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Fig. 1: The PFS of IgD myeloma patients stratified by optimizing response system (sCR 39 vs.CR 29 vs.

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Acknowledgements

RPG acknowledges support from the National Institute of Health Research (NIHR) Biomedical Research Center. YL and RPG was supported by the Ministry of Science and Technology of China (84000–51200002).

Funding

Supported, in part, by grants from the National Natural Science Foundation of China (NFSC 82170198 and NFSC 81870164) and Clinical Research Plan of SHDC.

Author information

Author notes

  1. These authors contributed equally: Jin Liu, Jing Lu, Yang Liang, Jian Hou, Juan Du.

Authors and Affiliations

  1. Department of Hematology, Myeloma & Lymphoma Center, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China

    Jin Liu, Jing Lu, Wanting Qiang, Yanchun Jia, Haiyan He & Juan Du

  2. Department of health statistics, Naval Medical University (Second Military Medical University), Shanghai, China

    Xiaofei Ye

  3. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Wee Joo Chng

  4. Department of Haematology-Oncology, National University Cancer Institute Singapore, National University Health System, Singapore, Singapore

    Wee Joo Chng

  5. Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore

    Wee Joo Chng

  6. Hematology Research Centre, Department of Immunology and Inflammation, Imperial College of Science, Technology and Medicine, London, UK

    Robert Peter Gale

  7. Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China

    Yang Liang

  8. Department of Hematology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Jian Hou

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  1. Jin Liu
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Contributions

JD, JH and YL designed the study; JL and JL collected and analyzed the data; WQ. YJ, HH and XY treated the subjects; WJC and RPG analyzed the data and revised the typescript. All authors approved the final typescript and agreed to submit for publication.

Corresponding authors

Correspondence to Yang Liang, Jian Hou or Juan Du.

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Competing interests

RPG is a consultant to NexImmune Inc. Nanexa Pharma Ascentage Pharm Group and Antengene Biotech LLC, Medical Director of FFF Enterprises Inc.; Partner in AZAC Inc.; Board of Directors of Russian Foundation for Cancer Research Support and Scientific Advisory Board: StemRad Ltd.

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Liu, J., Lu, J., Qiang, W. et al. Sensitive quantitative IgD assay increases progression-free survival prediction accuracy in IgD plasma cell myeloma. Leukemia 37, 497–499 (2023). https://doi.org/10.1038/s41375-022-01777-w

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