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Clinical significance of the appearance of abnormal protein band in patients with multiple myeloma

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Abstract

Multiple myeloma (MM) is characterized by clonal expansion of malignant bone marrow cells producing a unique monoclonal immunoglobulin. The appearance of abnormal protein band (APB) in MM has been reported during follow-up. We aimed to evaluate the clinical characteristics and outcomes of patients with APB in a single center cohort. A total of 377 consecutive MM patients were treated at the Asan Medical Center between January 2002 and December 2012. We compared clinical characteristics and survival outcome between those with and without APB. Of the 377 patients, 34 (9 %) experienced APB. They comprised 18.2 % (27/148) of patients treated with autologous stem cell transplantation (ASCT) and 3.1 % (7/229) of those not receiving ASCT. APB occurred after a median of 7.9 months (range, 2.2–95.7 months) from diagnosis. Immunoglobulin isotypes at diagnosis were as follows: IgG (n = 10), IgA (n = 8), IgD (n = 5), free κ (n = 4), and free λ (n = 7). Nine patients experienced a second APB. With a median follow-up of 54.1 months, the median overall survival (OS) has not been reached in patients with APB and was 38.3 months in patients without (P < 0.001). Multivariate analysis indicated that the development of APB was a significant favorable prognostic factor for OS (hazard ratio 0.21; 95 % confidence interval 0.08–0.52). Serum β2-microglobulin, albumin, creatinine, and ASCT were also independent prognostic factors for OS. Further investigation is required to establish the mechanisms underlying APB in MM.

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Acknowledgments

The authors thank the nursing and medical staff of the Asan Medical Center for their excellent support and dedication that has made this study possible.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea

    Jae-Cheol Jo, Dok Hyun Yoon, Shin Kim, Kyoungmin Lee, Eun Hee Kang & Cheolwon Suh

  2. Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Seongsoo Jang, Chan-Jeoung Park & Hyun-Sook Chi

  3. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Jooryung Huh & Chan-Sik Park

  4. Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Ulsan, 682-714, South Korea

    Jae-Cheol Jo

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  1. Jae-Cheol Jo
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  2. Dok Hyun Yoon
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  3. Shin Kim
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  4. Kyoungmin Lee
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  9. Jooryung Huh
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  11. Cheolwon Suh
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Corresponding author

Correspondence to Cheolwon Suh.

Additional information

Jae-Cheol Jo and Dok Hyun Yoon contributed equally to this work.

Appendix

Appendix

Table 5 Published reports on the appearance of abnormal protein band in multiple myeloma
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Jo, JC., Yoon, D.H., Kim, S. et al. Clinical significance of the appearance of abnormal protein band in patients with multiple myeloma. Ann Hematol 93, 463–469 (2014). https://doi.org/10.1007/s00277-013-1890-2

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  • DOI: https://doi.org/10.1007/s00277-013-1890-2

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