INCREASED LEVELS OF SOLUBLE SYNDECAN-1 AND LDH ARE MAJOR PROGNOSTIC FACTORS FOR SUBSEQUENT OVERALL SURVIVAL AND PROGRESSION FREE SURVIVAL AFTER A RELAPSE IN MULTIPLE MYELOMA
(Abstract release date: 05/19/16)
EHA Library. Papanikolaou X. 06/09/16; 132817; E1268
Dr. Xenofon Papanikolaou
Contributions
Contributions
Abstract
Abstract: E1268
Type: Eposter Presentation
Background
Despite the recent advances in the therapy of Multiple Myeloma (MM), a relapse is almost a universal phenomenon in the clinical course of the disease. Nevertheless only few are known about the prognostic factors that characterize the relapses in MM, since robust and easily accessible prognostic factors as the levels of soluble Syndecan-1 (sS-1) or the ratio of involved to uninvolved free light chains in the serum (FLCR) have been verified only in newly diagnosed cases of MM.
Aims
A series of 245 MM patients with at least one relapse in their disease course, was studied to identify the prognostic factors that govern the prognosis of relapse in MM.
Methods
sS-1 levels in the serum were measured through the commercially available Diaclone™ ELISA kits. Survival statistical analysis was performed using the SPSS v22 statistical software. The running log rank method was used for the establishment of the optimal threshold of numerical variables. Clinical and laboratory values used were the ones closest to an established relapse and prior to the salvage treatment.
Results
From 01/01/2000 till 20/06/2014, 245 patients with symptomatic MM and at least one relapse were recorded for a total of 803 relapses.56 patients had 1 relapse, 51 patients 2 relapses, 48 patients 3 relapses and 90 patients more than 3. The clinical and laboratory characteristics of the relapses are presented in Table 1. The median Overall Survival (OS) and median Progression Free Survival (PFS) after a relapse were 1.7 and 0.9 years (yr) respectively. For the first relapse OS and PFS were 3.3 and 1.3 years, for the second relapse OS and PFS were 2.1 and 1 yr, for the third relapse OS and PFS were 1.2 and 0.8 yr, while for the fourth and above OS and PFS were 0.8 and 0.4 yr respectively.Statistically significant variables for the prediction of subsequent OS after a relapse in univariate analysis were: ISS stage III (HR:1.26, P<0.001), male sex (HR:1.39, P<0.001), sS-1>245 ng/mL (HR:2.56, P<0.001), LDH>480 IU/L (HR:1.99, P<0.001), number of prior relapses (HR:1.02, P=0.002) and response to treatment (HR:1.16, P<0.001). For the prognostication of subsequent PFS, the following factors were significant in univariate analysis: age≥65 years (HR:1.07, P=0.02), sS-1>245 ng/mL (HR:2.29, P=0.001), LDH>480 IU/L (HR:1.53, P=0.003), number of prior relapses (HR:1.14, P<0.001) and response to treatment (HR:1.12, P<0.001). Multivariate analysis revealed sS-1>245 ng/mL and LDH>480 IU/L as the only statistically significant factors for both OS and PFS. sS-1>245 ng/mL and LDH>480 IU/L retained their statistical significance both for univariate and multivariate analysis even when the subgroup of relapses treated with novel agents was independently studied.Table 1 Characteristics of MM relapses
Conclusion
In conclusion both OS and PFS are gradually declining after each relapse. While both the number of prior relapses and the response to salvage treatment are important prognostic factors, subsequent OSand PFS are mainly dictated by the levels of sS-1 and LDH that characterize the MM relapse.
Session topic: E-poster
Keyword(s): Myeloma, Relapse, Syndecan-1
Type: Eposter Presentation
Background
Despite the recent advances in the therapy of Multiple Myeloma (MM), a relapse is almost a universal phenomenon in the clinical course of the disease. Nevertheless only few are known about the prognostic factors that characterize the relapses in MM, since robust and easily accessible prognostic factors as the levels of soluble Syndecan-1 (sS-1) or the ratio of involved to uninvolved free light chains in the serum (FLCR) have been verified only in newly diagnosed cases of MM.
Aims
A series of 245 MM patients with at least one relapse in their disease course, was studied to identify the prognostic factors that govern the prognosis of relapse in MM.
Methods
sS-1 levels in the serum were measured through the commercially available Diaclone™ ELISA kits. Survival statistical analysis was performed using the SPSS v22 statistical software. The running log rank method was used for the establishment of the optimal threshold of numerical variables. Clinical and laboratory values used were the ones closest to an established relapse and prior to the salvage treatment.
Results
From 01/01/2000 till 20/06/2014, 245 patients with symptomatic MM and at least one relapse were recorded for a total of 803 relapses.56 patients had 1 relapse, 51 patients 2 relapses, 48 patients 3 relapses and 90 patients more than 3. The clinical and laboratory characteristics of the relapses are presented in Table 1. The median Overall Survival (OS) and median Progression Free Survival (PFS) after a relapse were 1.7 and 0.9 years (yr) respectively. For the first relapse OS and PFS were 3.3 and 1.3 years, for the second relapse OS and PFS were 2.1 and 1 yr, for the third relapse OS and PFS were 1.2 and 0.8 yr, while for the fourth and above OS and PFS were 0.8 and 0.4 yr respectively.Statistically significant variables for the prediction of subsequent OS after a relapse in univariate analysis were: ISS stage III (HR:1.26, P<0.001), male sex (HR:1.39, P<0.001), sS-1>245 ng/mL (HR:2.56, P<0.001), LDH>480 IU/L (HR:1.99, P<0.001), number of prior relapses (HR:1.02, P=0.002) and response to treatment (HR:1.16, P<0.001). For the prognostication of subsequent PFS, the following factors were significant in univariate analysis: age≥65 years (HR:1.07, P=0.02), sS-1>245 ng/mL (HR:2.29, P=0.001), LDH>480 IU/L (HR:1.53, P=0.003), number of prior relapses (HR:1.14, P<0.001) and response to treatment (HR:1.12, P<0.001). Multivariate analysis revealed sS-1>245 ng/mL and LDH>480 IU/L as the only statistically significant factors for both OS and PFS. sS-1>245 ng/mL and LDH>480 IU/L retained their statistical significance both for univariate and multivariate analysis even when the subgroup of relapses treated with novel agents was independently studied.Table 1 Characteristics of MM relapses
Conclusion
In conclusion both OS and PFS are gradually declining after each relapse. While both the number of prior relapses and the response to salvage treatment are important prognostic factors, subsequent OSand PFS are mainly dictated by the levels of sS-1 and LDH that characterize the MM relapse.
Session topic: E-poster
Keyword(s): Myeloma, Relapse, Syndecan-1
Abstract: E1268
Type: Eposter Presentation
Background
Despite the recent advances in the therapy of Multiple Myeloma (MM), a relapse is almost a universal phenomenon in the clinical course of the disease. Nevertheless only few are known about the prognostic factors that characterize the relapses in MM, since robust and easily accessible prognostic factors as the levels of soluble Syndecan-1 (sS-1) or the ratio of involved to uninvolved free light chains in the serum (FLCR) have been verified only in newly diagnosed cases of MM.
Aims
A series of 245 MM patients with at least one relapse in their disease course, was studied to identify the prognostic factors that govern the prognosis of relapse in MM.
Methods
sS-1 levels in the serum were measured through the commercially available Diaclone™ ELISA kits. Survival statistical analysis was performed using the SPSS v22 statistical software. The running log rank method was used for the establishment of the optimal threshold of numerical variables. Clinical and laboratory values used were the ones closest to an established relapse and prior to the salvage treatment.
Results
From 01/01/2000 till 20/06/2014, 245 patients with symptomatic MM and at least one relapse were recorded for a total of 803 relapses.56 patients had 1 relapse, 51 patients 2 relapses, 48 patients 3 relapses and 90 patients more than 3. The clinical and laboratory characteristics of the relapses are presented in Table 1. The median Overall Survival (OS) and median Progression Free Survival (PFS) after a relapse were 1.7 and 0.9 years (yr) respectively. For the first relapse OS and PFS were 3.3 and 1.3 years, for the second relapse OS and PFS were 2.1 and 1 yr, for the third relapse OS and PFS were 1.2 and 0.8 yr, while for the fourth and above OS and PFS were 0.8 and 0.4 yr respectively.Statistically significant variables for the prediction of subsequent OS after a relapse in univariate analysis were: ISS stage III (HR:1.26, P<0.001), male sex (HR:1.39, P<0.001), sS-1>245 ng/mL (HR:2.56, P<0.001), LDH>480 IU/L (HR:1.99, P<0.001), number of prior relapses (HR:1.02, P=0.002) and response to treatment (HR:1.16, P<0.001). For the prognostication of subsequent PFS, the following factors were significant in univariate analysis: age≥65 years (HR:1.07, P=0.02), sS-1>245 ng/mL (HR:2.29, P=0.001), LDH>480 IU/L (HR:1.53, P=0.003), number of prior relapses (HR:1.14, P<0.001) and response to treatment (HR:1.12, P<0.001). Multivariate analysis revealed sS-1>245 ng/mL and LDH>480 IU/L as the only statistically significant factors for both OS and PFS. sS-1>245 ng/mL and LDH>480 IU/L retained their statistical significance both for univariate and multivariate analysis even when the subgroup of relapses treated with novel agents was independently studied.Table 1 Characteristics of MM relapses
Conclusion
In conclusion both OS and PFS are gradually declining after each relapse. While both the number of prior relapses and the response to salvage treatment are important prognostic factors, subsequent OSand PFS are mainly dictated by the levels of sS-1 and LDH that characterize the MM relapse.
Session topic: E-poster
Keyword(s): Myeloma, Relapse, Syndecan-1
Type: Eposter Presentation
Background
Despite the recent advances in the therapy of Multiple Myeloma (MM), a relapse is almost a universal phenomenon in the clinical course of the disease. Nevertheless only few are known about the prognostic factors that characterize the relapses in MM, since robust and easily accessible prognostic factors as the levels of soluble Syndecan-1 (sS-1) or the ratio of involved to uninvolved free light chains in the serum (FLCR) have been verified only in newly diagnosed cases of MM.
Aims
A series of 245 MM patients with at least one relapse in their disease course, was studied to identify the prognostic factors that govern the prognosis of relapse in MM.
Methods
sS-1 levels in the serum were measured through the commercially available Diaclone™ ELISA kits. Survival statistical analysis was performed using the SPSS v22 statistical software. The running log rank method was used for the establishment of the optimal threshold of numerical variables. Clinical and laboratory values used were the ones closest to an established relapse and prior to the salvage treatment.
Results
From 01/01/2000 till 20/06/2014, 245 patients with symptomatic MM and at least one relapse were recorded for a total of 803 relapses.56 patients had 1 relapse, 51 patients 2 relapses, 48 patients 3 relapses and 90 patients more than 3. The clinical and laboratory characteristics of the relapses are presented in Table 1. The median Overall Survival (OS) and median Progression Free Survival (PFS) after a relapse were 1.7 and 0.9 years (yr) respectively. For the first relapse OS and PFS were 3.3 and 1.3 years, for the second relapse OS and PFS were 2.1 and 1 yr, for the third relapse OS and PFS were 1.2 and 0.8 yr, while for the fourth and above OS and PFS were 0.8 and 0.4 yr respectively.Statistically significant variables for the prediction of subsequent OS after a relapse in univariate analysis were: ISS stage III (HR:1.26, P<0.001), male sex (HR:1.39, P<0.001), sS-1>245 ng/mL (HR:2.56, P<0.001), LDH>480 IU/L (HR:1.99, P<0.001), number of prior relapses (HR:1.02, P=0.002) and response to treatment (HR:1.16, P<0.001). For the prognostication of subsequent PFS, the following factors were significant in univariate analysis: age≥65 years (HR:1.07, P=0.02), sS-1>245 ng/mL (HR:2.29, P=0.001), LDH>480 IU/L (HR:1.53, P=0.003), number of prior relapses (HR:1.14, P<0.001) and response to treatment (HR:1.12, P<0.001). Multivariate analysis revealed sS-1>245 ng/mL and LDH>480 IU/L as the only statistically significant factors for both OS and PFS. sS-1>245 ng/mL and LDH>480 IU/L retained their statistical significance both for univariate and multivariate analysis even when the subgroup of relapses treated with novel agents was independently studied.Table 1 Characteristics of MM relapses
Conclusion
In conclusion both OS and PFS are gradually declining after each relapse. While both the number of prior relapses and the response to salvage treatment are important prognostic factors, subsequent OSand PFS are mainly dictated by the levels of sS-1 and LDH that characterize the MM relapse.
Session topic: E-poster
Keyword(s): Myeloma, Relapse, Syndecan-1
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