Contributions
Abstract: PB2174
Type: Publication Only
Background
to formulate the concept of intrathecal tumor growth in patients with multiple myeloma (MM), complicated by myeloradiculopathy based on model concentration gradients of free light chains in serum ( sFLC) and the free light chain in cerebrospinal fluid ( FLC CSF ).
Aims
to formulate the concept of intrathecal tumor growth in patients with multiple myeloma (MM), complicated by myeloradiculopathy based on model concentration gradients of free light chains in serum ( sFLC) and the free light chain in cerebrospinal fluid ( FLC CSF ).
Methods
12 patients with MM complicated by myeloradiculopathy were included in this study. Paraprotein (PIg) G was determined in 6 patients (κ - at 3; λ - in 3) , PIg M / κ – in 1 patient, an isolated BJ disease - in 5 patients (λ- 5 ). A newly diagnosed MM was present in 5 patients, a resistant MM - in 4 patients; 3 patients were receiving maintenance treatment during the study. All patients received chemotherapy treatment, including bortezomib, melphalan (cyclophosphamide) and prednisone (dexamethasone), lenalidomide administered when tumor resistance occurred. Concentrations of sFLCand FLC CSF were measured by ELISA method on a spectrophotometer (Kenstar, USA).
Results
the average concentrations of κ- sFLC was 15,9 ± 4 mg/l, which was greater than this value for healthy individuals (7,3 mg/l). Distribution of values for concentrations reached 6,7 ± 2 and 28,9 ± 7 mg/l. The average value of κ- FLC CSF was 0,03 ± 0,01 mg/l with a distribution of 0,02 ± 0,05 and 0,05 ± 0,02 mg/l . The average concentration of λ- sFLC was 54,3 ± 16,4 mg/l (values for healthy individuals - 12.7 mg/l ), with distribution of 12,6 and 98,7 mg/l. Concentration of λ -FLC CSF was 0.5 ± 0.18 mg/l with a distribution of 0.17 and 0.83 mg/l. To determine the concentration gradient for sFLC and FLC CSF the concentrations of κ- and λ – FLC were determined in serum and in cerebrospinal fluid. The ratios for FLC concentration in serum vs FLC concentration in cerebrospinal fluid were calculated for κ- FLC and for λ – FLC, which was 1,7 and 1,6 respectively. Comparison of this model with the performance of each patient showed that 6 out of 12 results were below the 1.7 or 1.6, indicating an intrathecal growth. Tumor cytosis in cerebrospinal fluid was determined in one case.Conclusion
results of this study could serve as indicators for intrathecal chemotherapy for MM complicated by tumor myeloradiculopathy.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Abstract: PB2174
Type: Publication Only
Background
to formulate the concept of intrathecal tumor growth in patients with multiple myeloma (MM), complicated by myeloradiculopathy based on model concentration gradients of free light chains in serum ( sFLC) and the free light chain in cerebrospinal fluid ( FLC CSF ).
Aims
to formulate the concept of intrathecal tumor growth in patients with multiple myeloma (MM), complicated by myeloradiculopathy based on model concentration gradients of free light chains in serum ( sFLC) and the free light chain in cerebrospinal fluid ( FLC CSF ).
Methods
12 patients with MM complicated by myeloradiculopathy were included in this study. Paraprotein (PIg) G was determined in 6 patients (κ - at 3; λ - in 3) , PIg M / κ – in 1 patient, an isolated BJ disease - in 5 patients (λ- 5 ). A newly diagnosed MM was present in 5 patients, a resistant MM - in 4 patients; 3 patients were receiving maintenance treatment during the study. All patients received chemotherapy treatment, including bortezomib, melphalan (cyclophosphamide) and prednisone (dexamethasone), lenalidomide administered when tumor resistance occurred. Concentrations of sFLCand FLC CSF were measured by ELISA method on a spectrophotometer (Kenstar, USA).
Results
the average concentrations of κ- sFLC was 15,9 ± 4 mg/l, which was greater than this value for healthy individuals (7,3 mg/l). Distribution of values for concentrations reached 6,7 ± 2 and 28,9 ± 7 mg/l. The average value of κ- FLC CSF was 0,03 ± 0,01 mg/l with a distribution of 0,02 ± 0,05 and 0,05 ± 0,02 mg/l . The average concentration of λ- sFLC was 54,3 ± 16,4 mg/l (values for healthy individuals - 12.7 mg/l ), with distribution of 12,6 and 98,7 mg/l. Concentration of λ -FLC CSF was 0.5 ± 0.18 mg/l with a distribution of 0.17 and 0.83 mg/l. To determine the concentration gradient for sFLC and FLC CSF the concentrations of κ- and λ – FLC were determined in serum and in cerebrospinal fluid. The ratios for FLC concentration in serum vs FLC concentration in cerebrospinal fluid were calculated for κ- FLC and for λ – FLC, which was 1,7 and 1,6 respectively. Comparison of this model with the performance of each patient showed that 6 out of 12 results were below the 1.7 or 1.6, indicating an intrathecal growth. Tumor cytosis in cerebrospinal fluid was determined in one case.Conclusion
results of this study could serve as indicators for intrathecal chemotherapy for MM complicated by tumor myeloradiculopathy.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical