المؤلفون: Puig, Noemí, Contreras, María Teresa, Agulló, Cristina, Martínez López, Joaquín, Oriol Bosch, Albert, Blanchard, María Jesús, Ríos, Rafael, Martín, Jesús, Iñigo, María Belén, Sureda, Anna, Hernández, Miguel Teodoro, De La Rubia, Javier, González Calle, Verónica, Krsnik, Isabel, Cabañas, Valentín, Palomera, Luis, Moraleda, José María, Bargay, Joan, Cedena, María Teresa, Paiva, Bruno, Rosiñol, Laura, Bladé, J. (Joan), San Miguel, Jesús, Lahuerta, Juan José, Mateos, María Victoria

المصدر: Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

مصطلحات موضوعية: Anticossos monoclonals, Espectrometria de masses, Monoclonal antibodies

الوصف: Monitoring of the monoclonal protein (M-protein) by electrophoresis and/or immunofixation (IFE) has long been used to assess treatment response in multiple myeloma (MM). However, with the use of highly effective therapies, the M-protein becomes frequently undetectable, and more sensitive methods had to be explored. We applied IFE and mass spectrometry (EXENT&FLC-MS) in serum samples from newly diagnosed MM patients enrolled in the PETHEMA/GEM2012MENOS65 obtained at baseline (n = 223), and after induction (n = 183), autologous stem cell transplantation (n = 173), and consolidation (n = 173). At baseline, the isotypes identified with both methods fully matched in 82.1% of samples; in the rest but 2 cases, EXENT&FLC-MS provided additional information to IFE with regards to the M-protein(s). Overall, the results of EXENT&FLC-MS and IFE were concordant in >80% of cases, being most discordances due to EXENT&FLC-MS+ but IFE cases. After consolidation, IFE was not able to discriminate 2 cohorts with different median progression-free survival (PFS), but EXENT&FLC-MS did so; furthermore, among IFE patients, EXENT&FLC-MS identified 2 groups with significantly different median PFS (P = .0008). In conclusion, compared with IFE, EXENT&FLC-MS is more sensitive to detect the M-protein of patients with MM, both at baseline and during treatment, and provides a more accurate prediction of patients' outcome.

وصف الملف: 6 p.; application/pdf

العلاقة: Reproducció del document publicat a: https://doi.org/10.1182/bloodadvances.2021006762Test; Blood Advances, 2022, vol. 6, núm. 11, p. 3234-3239; https://doi.org/10.1182/bloodadvances.2021006762Test; http://hdl.handle.net/2445/188952Test; 9298490

الإتاحة: https://doi.org/10.1182/bloodadvances.2021006762Test
http://hdl.handle.net/2445/188952Test

المؤلفون: Ríos-Tamayo, Rafael, Soler, Juan Alfons, García-Sánchez, Ricarda, Pérez Persona, Ernesto, Arnao, Mario, García-Guiñón, Antoni, Domingo, Abel, González-Pardo, Miriam, de la Rubia, Javier, Mateos, María Victoria

المصدر: Hematology; Dec2023, Vol. 28 Issue 1, p1-11, 11p

مصطلحات موضوعية: MULTIPLE myeloma, MONOCLONAL antibodies, CLINICAL trials, PROGRESSION-free survival

مستخلص: To describe the incorporation of monoclonal antibodies (mAb) in real-world (RW) practice for the treatment of patients with relapsed refractory multiple myeloma (RRMM) in a setting with other treatment alternatives. This was an observational, multicenter, ambispective study of RRMM treated with or without a mAb. A total of 171 patients were included. For the group treated without mAb, the median (95% CI) progression-free survival (PFS) to relapse was 22.4 (17.8-27.0) months; partial response or better (≥PR) and complete response or better (≥CR) was observed in 74.1% and 24.1% of patients, respectively; and median time to first response in first relapse was 2.0 months and in second relapse was 2.5 months. For the group of patients treated with mAb in first or second relapse, the median PFS was 20.9 (95% CI, could not be evaluated) months; the ≥ PR and ≥ CR rates were 76,2% and 28.6%, respectively; and the median time to first response in first relapse was 1.2 month and in second relapse was 1.0 months. The safety profiles for the combinations were consistent with those expected. The incorporation of mAb in RW practice for the treatment of RRMM has shown good quality and speed of response with a similar safety profile shown in randomized clinical trials. [ABSTRACT FROM AUTHOR]

: Copyright of Hematology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Cárdenas, María C., García-Sanz, Ramón, Puig, Noemí, Pérez-Surribas, David, Flores-Montero, Juan, Ortiz-Espejo, María, de la Rubia, Javier, Cruz-Iglesias, Elena

المصدر: Clinical Chemistry & Laboratory Medicine; Nov2023, Vol. 61 Issue 12, p2115-2130, 16p

مصطلحات موضوعية: MONOCLONAL gammopathies, MONOCLONAL antibodies, IMMUNOGLOBULIN light chains, BONE marrow examination, BLOOD transfusion, HEMATOLOGY

مستخلص: Monoclonal gammopathies (MG) are characterized by the proliferation of plasma cells that produce identical abnormal immunoglobulins (intact or some of their subunits). This abnormal immunoglobulin component is called monoclonal protein (M-protein), and is considered a biomarker of proliferative activity. The identification, characterization and measurement of M-protein is essential for the management of MG. We conducted a systematic review of the different tests and measurement methods used in the clinical laboratory for the study of M-protein in serum and urine, the biochemistry and hematology tests necessary for clinical evaluation, and studies in bone marrow, peripheral blood and other tissues. This review included literature published between 2009 and 2022. The paper discusses the main methodological characteristics and limitations, as well as the purpose and clinical value of the different tests used in the diagnosis, prognosis, monitoring and assessment of treatment response in MG. Included are methods for the study of M-protein, namely electrophoresis, measurement of immunoglobulin levels, serum free light chains, immunoglobulin heavy chain/light chain pairs, and mass spectrometry, and for the bone marrow examination, morphological analysis, cytogenetics, molecular techniques, and multiparameter flow cytometry. [ABSTRACT FROM AUTHOR]

: Copyright of Clinical Chemistry & Laboratory Medicine is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Cárdenas, María C., García-Sanz, Ramón, Puig, Noemí, Pérez-Surribas, David, Flores-Montero, Juan, Ortiz-Espejo, María, De la Rubia, Javier, Cruz-Iglesias, Elena

المصدر: Clinical Chemistry & Laboratory Medicine; Nov2023, Vol. 61 Issue 12, p2131-2142, 12p

مصطلحات موضوعية: MONOCLONAL gammopathies, BLOOD transfusion, PATHOLOGICAL laboratories, CLINICAL pathology, HEMATOLOGY, MONOCLONAL antibodies

مستخلص: Monoclonal gammopathies (MG) are a group of clinical entities characterized by the clonal expansion of monoclonal immunoglobulin (M-protein) secreting plasma cells (PC). This document presents the consensus recommendations of the Spanish Society of Laboratory Medicine (SEQC^ML) and the Spanish Society of Hematology and Hemotherapy (SEHH) for the study of MG. The recommendations were established based on scientific evidence and the opinion of experts in MG from the clinical laboratory and clinical hematology fields. Recommendations are proposed for the diagnosis of MG and for patient follow-up according to the type of MG and whether or not the patient is undergoing treatment, and to monitor the disease stability, response to therapy and disease progression. With respect to the diagnosis, we describe the most recent criteria and classification established by the International Myeloma Working Group (IMWG) for multiple myeloma (MM), smoldering MM, monoclonal gammopathy of undermined significance (MGUS) and other related entities. Indications are given about the analytical requirements and application of the different serum and urine laboratory tests (study, detection, identification and measurement of M-protein) and the bone marrow study. Recommendations on the clinical laboratory results report model are established to harmonize and ensure that all relevant information is available, including its content, expression, and interpretive comments. [ABSTRACT FROM AUTHOR]

: Copyright of Clinical Chemistry & Laboratory Medicine is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Puig, Noemí, Corchete-Sánchez, Luis A., Pérez-Morán, José J., Dávila, Julio, Paíno, Teresa, de la Rubia, Javier, Oriol, Albert, Martín-Sánchez, Jesús, de Arriba, Felipe, Bladé, Joan, Blanchard, María-Jesús, González-Calle, Verónica, García-Sanz, Ramón, Paiva, Bruno, Lahuerta, Juan-José, San-Miguel, Jesús F., Mateos, María-Victoria, Ocio, Enrique M.

المصدر: Cancers; Dec2020, Vol. 12 Issue 12, p3615, 1p

مصطلحات موضوعية: THERAPEUTIC use of monoclonal antibodies, CLINICAL trials, DIARRHEA, DRUG efficacy, FLOW cytometry, IMMUNOTHERAPY, KILLER cells, MEMBRANE proteins, MONOCLONAL antibodies, MULTIPLE myeloma, MUSCLE proteins, T cells, TUMOR markers, PROGRAMMED cell death 1 receptors, IMMUNE checkpoint inhibitors, CHEMICAL inhibitors, THERAPEUTICS

مستخلص: Simple Summary: Multiple myeloma patients with persistent disease after treatment show increased expression of PDL1 in tumor plasma cells and of PD1 in T lymphocytes. This suggests a role of the PD1/PDL1 axis in treatment failure that could potentially be reverted with pembrolizumab, an anti-PD1 monoclonal antibody. The GEM-Pembresid trial enrolled 20 patients with multiple myeloma achieving a suboptimal response to the previous treatment that received intravenous pembrolizumab every 3 weeks with the objective of eradicating the residual disease. Pembrolizumab was acceptably well tolerated in the 17 patients evaluable for safety, but no improvement in the baseline responses was documented. Although no determinants of response could be identified, we detected a lower expression of PD1/PDL1 in a subgroup of patients progressing in the first 4 months after enrollment; furthermore, a reduction in the percentage of NK cells induced by pembrolizumab was observed. PD1 expression in CD4⁺ and CD8⁺ T cells is increased after treatment in multiple myeloma patients with persistent disease. The GEM-Pembresid trial analyzed the efficacy and safety of pembrolizumab as consolidation in patients achieving at least very good partial response but with persistent measurable disease after first- or second-line treatment. Moreover, the characteristics of the immune system were investigated to identify potential biomarkers of response to pembrolizumab. One out of the 17 evaluable patients showed a decrease in the amount of M-protein, although a potential late effect of high-dose melphalan could not be ruled out. Fourteen adverse events were considered related to pembrolizumab, two of which (G3 diarrhea and G2 pneumonitis) prompted treatment discontinuation and all resolving without sequelae. Interestingly, pembrolizumab induced a decrease in the percentage of NK cells at cycle 3, due to the reduction of the circulating and adaptive subsets (0.615 vs. 0.43, p = 0.007; 1.12 vs. 0.86, p = 0.02). In the early progressors, a significantly lower expression of PD1 in CD8⁺ effector memory T cells (MFI 1327 vs. 926, p = 0.03) was observed. In conclusion, pembrolizumab used as consolidation monotherapy shows an acceptable toxicity profile but did not improve responses in this MM patient population. The trial was registered at clinicaltrials.gov with identifier NCT02636010 and with EUDRACT number 2015-003359-23. [ABSTRACT FROM AUTHOR]

: Copyright of Cancers is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)