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Abstract
Background
Oligoclonal bands or isotype switch detectable by serum immunofixation electrophoresis (IFE) has been reported following chemotherapy and stem cell transplantation in patients with multiple myeloma (MM). We studied the significance of oligoclonal bands appearing after chemotherapy and autologous stem cell transplantation (ASCT) in Korean MM patients, and its impact on relapse. And we investigated the serial serum free light chain (FLC) ratio to establish its possible relationship with the relapse of MM.
Methods
We conducted a retrospective analysis of the serial serum IFE and FLC ratio in 16 MM patients treated with chemotherapy and ASCT.
Results
Eleven out of 16 patients (68.8%) had oligoclonal bands with or without isotype switch after ASCT and the median interval from transplantation was 2.0 months. And relapse or persistence rate of monoclonal gammopathy was lower in patients with oligoclonal bands (27.3% vs. 60.0%), though without statistical significance (P=0.299). In eight patients who developed oligoclonal bands and did not relapse, the serial serum FLC ratio was normal in range. But one patient who developed oligoclonal bands and showed increase of plasma cells in bone marrow, the serial serum FLC ratio was abnormal in range.
Conclusions
The occurrence of oligoclonal bands after chemotherapy and ASCT in Korean MM patients is not significantly associated with adverse consequence of relapse or persistence of monoclonal gammopathy. Therefore oligoclonal bands may be not bad prognostic criterion. And the measurement of serum FLC ratio may be a useful indicator to predict relapse in MM patients who developed oligoclonal bands.
Figures and Tables
Fig. 1
Oligoclonal bands by serum IFE (case 4). (A) Gel shows a κ monoclonal band that resolved with pretransplant chemotherapy. (B) Two months after ASCT: Gel shows IgG κ and IgG λ oligoclonal bands.
Fig. 2
Isotype switch by serum IFE (case 3). (A) Gel shows an IgG κ monoclonal band. (B) Three months after ASCT: Gel shows a single IgM λ band.
Fig. 3
Flow chart of results of the study.
Abbreviations: MM, multiple myeloma; ASCT, autologous stem cell transplantation; OB, oligoclonal bands; IS, isotype switch; MC, monoclonal component.
References
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