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The presence of two light chain bands on immunofixation is associated with poor outcomes in newly diagnosed multiple myeloma patients

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Abstract

We aimed to describe the clinical and biological characteristics and the prognosis of patients presenting with an additional light chain (LC) band along with a complete monoclonal protein on immunofixation (IF).

An 8-year descriptive study was conducted to assess all cases with confirmed monoclonal gammopathies (MG). We studied those with an entire M-protein with 2 bands of LC of the same isotype based on the results of IF. Data were collected from patients’ files.

Among 548 cases of MG, we found 32 cases (5.8%) with an additional LC band. We included 28 patients (5%) with a confirmed diagnosis of multiple myeloma (MM). The m/f ratio was 2.5 with a median age of 63 years [32–80 years]. All MM patients had anemia, 16 (57%) had renal failure, 14 (50%) had lytic lesions, 9 (32%) received hemodialysis, and 7 (25%) had hypercalcemia. The free-kappa–lambda ratio was abnormal in all cases: median = 0.07 [0.002–58.57]. The mean overall survival (OS) was 22 months ± 38.76.

Fifteen MM patients (48%) received chemotherapy, and 7 (22%) autologous stem cell transplants (SCT). Patients who received SCT had an OS higher than those who received other treatments (p = 0.038). OS was low in patients with high β2microglobulin levels (rho = -0.791; p = 0.001), and abnormally low free-kappa–lambda ratio (rho = -0.852;p = 0.04).

The presence of an additional LC band with a complete monoclonal protein seems to identify newly diagnosed MM patients with poor outcomes and frequent renal impairment.

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Authors and Affiliations

  1. Immunology Department, Habib Bourguiba University Hospital, University of Sfax, 3000, Sfax, Tunisia

    Ameni Jerbi, Omar Turki, Hend Hachicha, Sawsan Feki, Sabrina Mejdoub & Hatem Masmoudi

  2. Hematology Department, Hedi Chaker University Hospital, University of Sfax, 3000, Sfax, Tunisia

    Faten Kallel Sarbeji & Moez Elloumi

  3. Nephrology Department, Hedi Chaker University Hospital, University of Sfax, 3000, Sfax, Tunisia

    Khaoula Kammoun & Mohamed Ben Hmida

Authors
  1. Ameni Jerbi
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  2. Omar Turki
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  7. Khaoula Kammoun
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  8. Mohamed Ben Hmida
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  10. Hatem Masmoudi
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Contributions

All authors contributed to the study's conception and design. Material preparation, data collection, and analysis were performed by [Ameni Jerbi], [Turki Omar], [Faten KALLEL SARBEJI], [Khaoula KAMMOUN], and [Hend Hachicha].

[Mohamed BEN HMIDA], [Moez ELLOUMI], and [Hatem MASMOUDI] supervised this study.

The first draft of the manuscript was written by [Ameni Jerbi] and all authors commented on previous versions of the manuscript.

All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ameni Jerbi.

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Because this was a retrospective study, the requirement for informed consent was not possible.

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Jerbi, A., Turki, O., Hachicha, H. et al. The presence of two light chain bands on immunofixation is associated with poor outcomes in newly diagnosed multiple myeloma patients. Ann Hematol 102, 1459–1466 (2023). https://doi.org/10.1007/s00277-023-05221-6

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  • DOI: https://doi.org/10.1007/s00277-023-05221-6

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