Response comparison of multiple myeloma and monoclonal gammopathy of undetermined significance to the same anti-myeloma therapy: a retrospective cohort.

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Response comparison of multiple myeloma and monoclonal gammopathy of undetermined significance to the same anti-myeloma therapy: a retrospective cohort study John P Campbell, PhD, Jennifer L J Heaney, PhD, Sankalp Pandya, MRes, Zaheer Afzal, MSc, Martin Kaiser, MD, Roger Owen, MD, Prof J Anthony Child, MD, David A Cairns, PhD, Prof Walter Gregory, PhD, Prof Gareth J Morgan, MD, Prof Graham H Jackson, MD, Prof Chris M Bunce, PhD, Prof Mark T Drayson, MD The Lancet Haematology Volume 4, Issue 12, Pages e584-e594 (December 2017) DOI: 10.1016/S2352-3026(17)30209-0 Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 1 M1 and M2 monoclonal antibodies from disease presentation to the time of maximum response to anti-multiple myeloma therapy Responses are coded on the basis of whether the M1 and M2 clone exhibited matched (red circles) or different (clear circles) light-chain isotypes. Of the 44 patients, data for one patient were not plotted as the patient exhibited progression of M1 and stable M2 in response to anti-myeloma therapy. M1=multiple myeloma monoclonal antibody. M2=monoclonal gammopathy of undetermined significance monoclonal antibody. The Lancet Haematology 2017 4, e584-e594DOI: (10.1016/S2352-3026(17)30209-0) Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 2 M1 and M2 monoclonal antibodies from diagnosis to the time of maximum response to different anti-multiple myeloma therapies Data are from 44 patients with biclonal gammopathy multiple myeloma; one patient was tabulated but only partly plotted because the patient exhibited disease progression of M1 and stable disease of M2 in response to melphalan and prednisone therapy. Boxplots represent median and IQR, and whiskers represent lowest and highest non-outlier values; outliers are represented by red dots (>1·5 × IQR) and clear dots (>3·0 × IQR). M1=multiple myeloma monoclonal antibody. M2=monoclonal gammopathy of undetermined significance monoclonal antibody. CVAD=cyclophosphamide, vincristine, doxorubicin, and dexamethasone. MP=melphalan and prednisone. MPT=melphalan, prednisolone, and thalidomide. CTD=cyclophosphamide, thalidomide, and dexamethasone. CTDa=attenuated CTD. CRD=cyclophosphamide, lenalidomide, and dexamethasone. CRDa=attenuated CRD. CCRD=carfilzomib and CRD. The Lancet Haematology 2017 4, e584-e594DOI: (10.1016/S2352-3026(17)30209-0) Copyright © 2017 Elsevier Ltd Terms and Conditions

Figure 3 Flow diagram Relapse among the 44 patients with biclonal gammopathy multiple myeloma after maximum response to anti-multiple myeloma therapy. M1=multiple myeloma monoclonal antibody. M2=monoclonal gammopathy of undetermined significance monoclonal antibody. The Lancet Haematology 2017 4, e584-e594DOI: (10.1016/S2352-3026(17)30209-0) Copyright © 2017 Elsevier Ltd Terms and Conditions