Abstract
Association of immunoglobulin isotypes with survival in the context of modern prognostic factors has not been determined. We utilized the Flatiron Health Electronic Health Record database and identified 8468 MM patients. Compared to IgG MM, patients with IgA MM were more likely to have ISS-III, anemia, and t(4;14), and light chain (LC) MM had higher renal dysfunction and t(11;14). IgA and LC MM patients have an inferior OS. The adverse prognostic impact of IgA and LC isotypes on OS persisted even after adjustment for variables impacting outcomes and likely suggests their unique biology beyond the presence of adverse prognostic factors.
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SB, SG, and LC conceptualized the study, the study design, and the methodology; curated and analyzed the data; and performed the analyses, and SB, SG, KG, and LC perform the investigation, wrote the original draft of the article, and reviewed and edited it.
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SB has received research funding from Amyloid Foundation. SG is supported in part by the Walter B. Frommeyer Fellowship in Investigative Medicine at the University of Alabama at Birmingham and reports receiving research funding from Carevive Systems and Pack Health. KG does not have any relevant disclosures. LJC receives honoraria from Amgen, Bristol-Myers Squibb, AbbVie, and Janssen, and grant/research support from Amgen, Bristol-Myers Squibb, AbbVie, and Janssen.
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277_2022_4783_MOESM1_ESM.pptx
Supplemental Figure 1. Derived progression free survival (dPFS) outcomes by immunoglobulin isotype. Kaplan–Meier curves showing comparison of dPFS for IgG, IgA, Light chain and other subgroups. (PPTX 169 KB)
277_2022_4783_MOESM2_ESM.pptx
Supplemental Figure 2. Overall survival outcomes by immunoglobulin isotype among patients underwent high dose therapy and autologous hematopoietic stem transplantation (AHCT). Kaplan–Meier curves showing comparison of overall survival (OS) for IgG, IgA, Light chain and other subgroups among patients who underwent AHCT. (PPTX 146 KB)
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Supplemental Table. Multivariable Analysis, ISS: International Staging System; ECOG: Eastern Cooperative Oncology Group; LDH: Lactate Dehydrogenase; ULN: Upper Limit Normal; Ch1a: Chromosome 1 Abnormalities; F: Female; M: Male; NHW: Non Hispanic White; NHB: Non Hispanic Black; Other: Biclonal and IgE MM; HR: Hazard Ratio (XLSX 12 KB)
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Bal, S., Giri, S., Godby, K.N. et al. Revisiting the impact of immunoglobulin isotypes in multiple myeloma. Ann Hematol 101, 825–829 (2022). https://doi.org/10.1007/s00277-022-04783-1
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DOI: https://doi.org/10.1007/s00277-022-04783-1