PMID- 27250604
OWN - NLM
STAT- MEDLINE
DCOM- 20160728
LR  - 20181202
IS  - 0042-773X (Print)
IS  - 0042-773X (Linking)
VI  - 62
IP  - 4
DP  - 2016 Apr
TI  - [Analysis of serum free light chains kappa/lambda ratio and heavy/light chain pairs of 
      immunoglobulin to the stratification of multiple myeloma according to Mayo 
      Stratification of Myeloma and Revised International Staging System].
PG  - 269-80
AB  - INTRODUCTION: Assessment of serum levels of free light chains (FLC-kappa and FLC-lambda) 
      and recently heavy/light chain pairs of immunoglobulin (HLC-kappa and HLC-lambda) and 
      their ratio (FLC-r and HLC-r) has significantly enriched traditional algorithm of 
      multiple myeloma (MM) evaluation. The aim of the presented study was to assess 
      the relationship of classical prognostic parameters of MM, standard FLC-kappa/lambda and 
      HLC-kappa/lambda ratio ((s)FLC-r and (s)HLC-r), modified ratio of "involved/uninvolved" 
      FLC and HLC ((m)FLC-r and (m)HLC-r ), the difference between "involved - 
      uninvolved" FLC and HLC (FLC-dif. and HLC-dif.) to current stratification models 
      of MM based on the result of cytogenetic analysis. PATIENTS AND METHODS: In a 
      group of 97 patients with MM we assessed serum levels of FLC by FreeliteTM 
      method, and we calculated (s)FLC-r, (m)FLC-r and FLC-dif. indices by HevyliteTM 
      method. For cytogenetic analysis we used FICTION (fluorescence immunophenotyping 
      and interphase cytogenetics as a tool for the investigation of neoplasms). For MM 
      stratification we used standard staging systems according to Durie-Salmon (D-S) 
      and International Staging System (ISS) as well as novel stratification systems 
      based on the results of cytogenetic analysis, ie. "Mayo Stratification of Myeloma 
      and Risk-Adapted Therapy" (mSMART) and "Revised International Staging System" 
      (R-ISS). RESULTS: Stratification mSMART and R-ISS has significantly different 
      representation of "standard" or "low-risk" (71, 15.5, 11.3 a 29.9 %), 
      "intermediate risk" (15.5, 53.6, 34 a 33 %) and "high risk" patients (13.4, 30.9, 
      54.7 a 37.1 %) compared to standard staging systems. mSMART stratification was 
      compared to prognostic factors of MM (Hb, albumin, beta(2)-M, creatinine and LDH), 
      and the only significant relationship was found in the case of beta(2)-M, R-ISS had 
      relationship only to Hb and creatinine. In the case of D-S staging we found 
      significant relationship of stages 1-3 and substages A and B to the levels of 
      (m)FLC-r, FLC-dif. and (m)HLC-r, ISS had moreover relationship to k HLC-dif. and 
      MIg concentration. Analysis of mSMART stratification showed primarily significant 
      relationship of risk categories 1-3 to (m)FLC-r and (s)HLC-r indices, and R-ISS 
      to (m)HLC-r index and MIg concentration. In both cytogenetics-based 
      stratifications there was a lack of relationship to (s)FLC-r, FLC-dif. and 
      HLC-dif. indices. CONCLUSION: Comparison of the results of standard staging 
      systems according to D-S and ISS with cytogenetics based models mSMART and R-ISS 
      showed different representation of risk groups, and significantly different 
      relationship to classical prognostic factors together with original relationship 
      of sMART stratification to (m)FLC-r and (s)HLC-r, and R-ISS to (m)HLC-r and MIg 
      concentration.
FAU - Scudla, Vlastimil
AU  - Scudla V
FAU - Balcarkova, Jana
AU  - Balcarkova J
FAU - Lochman, Pavel
AU  - Lochman P
FAU - Vincova, Miroslava
AU  - Vincova M
FAU - Pika, Tomas
AU  - Pika T
FAU - Minarik, Jiri
AU  - Minarik J
FAU - Zapletalova, Jana
AU  - Zapletalova J
FAU - Jarosova, Marie
AU  - Jarosova M
LA  - cze
PT  - Journal Article
TT  - Analyza vztahu volnych lehkych retezcu kappa/lambda a paru tezkych/lehkych retezcu 
      imunoglobulinu ke stratifikaci mnohocetneho myelomu podle Mayo Stratification of 
      Myeloma and Revised International Staging System.
PL  - Czech Republic
TA  - Vnitr Lek
JT  - Vnitrni lekarstvi
JID - 0413602
RN  - 0 (Immunoglobulin Light Chains)
RN  - 0 (Immunoglobulin lambda-Chains)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Immunoglobulin Light Chains/*blood
MH  - Immunoglobulin lambda-Chains/*blood
MH  - Male
MH  - Middle Aged
MH  - Multiple Myeloma/blood/*pathology
MH  - Prognosis
EDAT- 2016/06/03 06:00
MHDA- 2016/07/29 06:00
CRDT- 2016/06/03 06:00
PHST- 2016/06/03 06:00 [entrez]
PHST- 2016/06/03 06:00 [pubmed]
PHST- 2016/07/29 06:00 [medline]
AID - 58292 [pii]
PST - ppublish
SO  - Vnitr Lek. 2016 Apr;62(4):269-80.