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dc.contributor.authorHeaney, JLJ
dc.contributor.authorCampbell, JP
dc.contributor.authorIqbal, G
dc.contributor.authorCairns, D
dc.contributor.authorRichter, A
dc.contributor.authorChild, JA
dc.contributor.authorGregory, W
dc.contributor.authorJackson, G
dc.contributor.authorKaiser, M
dc.contributor.authorOwen, R
dc.contributor.authorDavies, F
dc.contributor.authorMorgan, G
dc.contributor.authorDunn, J
dc.contributor.authorDrayson, MT
dc.date.accessioned2021-03-31T08:34:11Z
dc.date.available2021-03-31T08:34:11Z
dc.identifier.citationLeukemia, 2018, 32 (8), pp. 1727 - 1738
dc.identifier.issn0887-6924
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/4469
dc.identifier.eissn1476-5551
dc.identifier.doi10.1038/s41375-018-0163-4
dc.description.abstractWe measured immunosuppression at myeloma diagnosis and assessed the impact on survival in 5826 UK myeloma trial patients. Polyclonal immunoglobulin levels were below normal in 85% of patients and above normal in only 0.4% of cases for IgA, 0.2% for IgM and no cases for IgG. Immunoparesis had a greater impact in recent trials: median overall survival (OS) was up to 3 years longer for patients without immunoparesis compared to the old trials, less than 1 year longer. Median progression-free survival (PFS) was 39%, 36% and 57% longer for patients with normal IgG, IgA and IgM levels, respectively. The depth of IgM suppression, but not the depth of IgG or IgA suppression, was prognostic for survival: the most severely suppressed IgM tertile of patients OS was 0.9 years shorter than those in the top tertile, and 2.6 years shorter than OS of those with normal IgM levels (p = .007). The degree of suppression of polyclonal IgM levels below normal was associated with worse PFS (p = .0002). Infection does not appear to be the main mechanism through which immunoparesis affects survival. We hypothesise that IgM immunoparesis impacts through a combination of being associated with more aggressive disease and reduced immune surveillance against relapse.
dc.formatPrint-Electronic
dc.format.extent1727 - 1738
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectMultiple Myeloma
dc.subjectDisease Progression
dc.subjectImmunoglobulins
dc.subjectPrognosis
dc.subjectSurvival Rate
dc.subjectRetrospective Studies
dc.subjectFollow-Up Studies
dc.subjectImmune Tolerance
dc.subjectAged
dc.subjectFemale
dc.subjectMale
dc.titleCharacterisation of immunoparesis in newly diagnosed myeloma and its impact on progression-free and overall survival in both old and recent myeloma trials.
dc.typeJournal Article
dcterms.dateAccepted2018-04-27
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1038/s41375-018-0163-4
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfLeukemia
pubs.issue8
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Myeloma Group
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Myeloma Group
pubs.publication-statusPublished
pubs.volume32
pubs.embargo.termsNot known
icr.researchteamMyeloma Group
icr.researchteamMyeloma Groupen_US
dc.contributor.icrauthorKaiser, Martinen


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