Haematologica 2003 - Supplements

(β2m) & C reactive protein (CRP). Erythrocyte sedimentation
rate (ESR), tumor necrosis factor ∝ (TNF∝) and serum copper
(Co) were also analysed. Overall survival (OS) was performed by
Kaplan-Meier curves and subgroups were compared with the
logrank test.
Results: 27 pts have been eligible, male-female ratio 15/12,
median age 74 (59-87): only 18% pts were 100mmHg. There was a significant (p= 0.045) correlation
between ESR and Co. Raised β2m, TNF∝ and CRP were
demostrated in 80%, 79% and 44%. Only one pt could reach high
dose therapy and autologous stem cell transplant (but he relapsed
20 months later). Median OS has been 32.25 months. As might be
expected, we have seen shorter OS (p=0.043) for pts with β2m
>4 mg/dl vs 25% reduction).
10 of these 12 patients had day 28 SFL analysis with 3/10
patients continuing to respond, 1 patient showing an increase in
SFL and 6 patients showing no further improvement in SFL
levels. Paraprotein measurements taken at day 28, showed a
decrease in value (>25%) in 8/21 patients (38%). This was
compared directly to the free light chain results. Of these 8
patients, 5 had either a day 7 or day 14 sample for sfl analysis,
and all 5 patients showed a response in SFL levels by day 14. A
further 5 patients showed a delayed response (>28 days) to
treatment with a median time to best response of 5 months. In this
group 4 patients had day 7 or 14 samples for sfl levels which
showed a reduction in 3 patients and no change in 1 patient.
Conclusions: The use of the serum free light chain assay at early
time points in the treatment regime may predict for overall
response rate. Further studies are being undertaken to validate
these findings to see if an early fall in SFL levels can be used to
stratify those patients who will respond well to treatment with the
IMID CC-4047.
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PROGNOSIS IN MULTIPLE MYELOMA (MM) UNDER
CONVENTIONAL CHEMOTHERAPY. A MULTIVARITE
ANALYSIS OF A SERIES INCLUDING 644 PATIENS.
MI González-Fraile, R García-Sanz, JM Hernández, MJ
Moro, J Fernández-Calvo, F Ortega, A Bárez, J Galende,
RM López, JA Portero, MD Caballero, M González, JF San
Miguel. Castellano-Leonés
(Spain) Group for the Study of Monoclonal Gammapathies.
Hematology Department. University Hospital of Salamanca.
Background: Many clinical and biological variables are of
prognostic value in MM. However, most studies are incomplete
and lack on the analysis of several important variables.
Methods: In this study we analyzed the prognostic value of
several clinical and biological characteristics at diagnosis and
their impact on the overall survival in a series of 644 MM
patients treated without high dose therapy.
Results: The univariate analysis of the whole series identified 22
parameters studied at diagnosis that negatively influenced overall
survival: age >60 yr, plasma cell (PC) infiltration >10% assessed
by flow cytometry (FC) or >20% by morphology, ECOG
performance status ≥3, S-phase PC >3%, 2M >6 mg/L, LDH
>460 U/L, albumin ≤3.5 g/dL, advanced osteolytic bone lesions,
Durie & Salmon stage III, only light chain secretion, light chain
subtype, creatinine >2 mg/dL, urea >65 mg/dL, CRP >6 mg/dL,
calcemia ≥11.5 mg/dL, light chain proteinuria >1.8 g/day,
hemoglobin ≤8.5 g/dL, platelets100·109/L, plasma cell DNA
index 3%, BMPC by FC >10%, ECOG 3, age
>60 yr, β2M >6 mg/L, LDH >460 U/L and albumin ≤3.5 g/dL.
The combination of these seven factors allows making a powerful
prognostic system for the whole series discriminating three
different prognostic groups.
Conclusions: The present analysis of prognostic factors displayed
seven variables with an independent influence on survival in MM
reflecting that it remains as a heterogeneous disease. These
factors could be categorized into three groups: related to the host
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