Prognostic utility of serum free light chain ratios and heavy-light chain ratios in multiple myeloma in three PETHEMA/GEM phase III clinical trials
We investigated the prognostic impact and clinical utility of serum free light chains (sFLC) and serum heavy-light chains (sHLC) in patients with multiple myeloma treated according to the GEM2005MENOS65, GEM2005MAS65, and GEM2010MAS65 PETHEMA/GEM phase III clinical trials. Serum samples collected at...
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| Veröffentlicht in: | PloS one 2018-09, Vol.13 (9), p.e0203392-e0203392 |
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| creator | Lopez-Anglada, Lucia Cueto-Felgueroso, Cecilia Rosiñol, Laura Oriol, Albert Teruel, Ana Isabel Lopez de la Guia, Ana Bengoechea, Enrique Palomera, Luis de Arriba, Felipe Hernandez, Jose Mariano Granell, Miquel Peñalver, Francisco Javier Garcia-Sanz, Ramon Besalduch, Juan Gonzalez, Yolanda Martinez, Rafael Benigno Hernandez, Miguel Teodoro Gutierrez, Norma C Puerta, Paloma Valeri, Antonio Paiva, Bruno Blade, Joan Mateos, Maria-Victoria San Miguel, Jesus Lahuerta, Juan Jose Martinez-Lopez, Joaquin |
| description | We investigated the prognostic impact and clinical utility of serum free light chains (sFLC) and serum heavy-light chains (sHLC) in patients with multiple myeloma treated according to the GEM2005MENOS65, GEM2005MAS65, and GEM2010MAS65 PETHEMA/GEM phase III clinical trials. Serum samples collected at diagnosis were retrospectively analyzed for sFLC (n = 623) and sHLC (n = 183). After induction or autologous transplantation, 309 and 89 samples respectively were available for sFLC and sHLC assays. At diagnosis, a highly abnormal (HA) sFLC ratio (sFLCr) (32) was not associated with higher risk of progression. After therapy, persistence of involved-sFLC levels >100 mg/L implied worse survival (overall survival [OS], P = 0.03; progression-free survival [PFS], P = 0.007). Among patients that achieved a complete response, sFLCr normalization did not necessarily indicate a higher quality response. We conducted sHLC investigations for IgG and IgA MM. Absolute sHLC values were correlated with monoclonal protein levels measured with serum protein electrophoresis. At diagnosis, HA-sHLCrs (73) showed a higher risk of progression (P = 0.006). Additionally, involved-sHLC levels >5 g/L after treatment were associated with shorter survival (OS, P = 0.001; PFS, P = 0.018). The HA-sHLCr could have prognostic value at diagnosis; absolute values of involved-sFLC >100 mg/L and involved-sHLC >5 g/L could have prognostic value after treatment. |
| doi_str_mv | 10.1371/journal.pone.0203392 |
| format | Article |
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Serum samples collected at diagnosis were retrospectively analyzed for sFLC (n = 623) and sHLC (n = 183). After induction or autologous transplantation, 309 and 89 samples respectively were available for sFLC and sHLC assays. At diagnosis, a highly abnormal (HA) sFLC ratio (sFLCr) (<0.03 or >32) was not associated with higher risk of progression. After therapy, persistence of involved-sFLC levels >100 mg/L implied worse survival (overall survival [OS], P = 0.03; progression-free survival [PFS], P = 0.007). Among patients that achieved a complete response, sFLCr normalization did not necessarily indicate a higher quality response. We conducted sHLC investigations for IgG and IgA MM. Absolute sHLC values were correlated with monoclonal protein levels measured with serum protein electrophoresis. At diagnosis, HA-sHLCrs (<0.29 or >73) showed a higher risk of progression (P = 0.006). Additionally, involved-sHLC levels >5 g/L after treatment were associated with shorter survival (OS, P = 0.001; PFS, P = 0.018). The HA-sHLCr could have prognostic value at diagnosis; absolute values of involved-sFLC >100 mg/L and involved-sHLC >5 g/L could have prognostic value after treatment.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0203392</identifier><identifier>PMID: 30192814</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Autografts ; Biochemistry ; Biology and Life Sciences ; Care and treatment ; Chains ; Clinical trials ; Clinical Trials, Phase III as Topic ; Correlation analysis ; Development and progression ; Diagnosis ; Electrophoresis ; Hematology ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin Heavy Chains - blood ; Immunoglobulin Light Chains - blood ; Immunoglobulins ; Induction Chemotherapy ; Kaplan-Meier Estimate ; Leukemia ; Light ; Light chains ; Medical prognosis ; Medical research ; Medicine and Health Sciences ; Multiple myeloma ; Multiple Myeloma - blood ; Multiple Myeloma - therapy ; Patients ; Prognosis ; Proteins ; Ratios ; Research and analysis methods ; Retrospective Studies ; Stem Cell Transplantation - methods ; Studies ; Survival ; Transplantation ; Transplantation, Autologous</subject><ispartof>PloS one, 2018-09, Vol.13 (9), p.e0203392-e0203392</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Lopez-Anglada et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Lopez-Anglada et al 2018 Lopez-Anglada et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c718t-4987b9d6af71ffadce6eb93c820edc95be95308850bd7abb77a6844b7ad303963</citedby><cites>FETCH-LOGICAL-c718t-4987b9d6af71ffadce6eb93c820edc95be95308850bd7abb77a6844b7ad303963</cites><orcidid>0000-0003-1727-8546</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128544/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128544/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30192814$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lopez-Anglada, Lucia</creatorcontrib><creatorcontrib>Cueto-Felgueroso, Cecilia</creatorcontrib><creatorcontrib>Rosiñol, Laura</creatorcontrib><creatorcontrib>Oriol, Albert</creatorcontrib><creatorcontrib>Teruel, Ana Isabel</creatorcontrib><creatorcontrib>Lopez de la Guia, Ana</creatorcontrib><creatorcontrib>Bengoechea, Enrique</creatorcontrib><creatorcontrib>Palomera, Luis</creatorcontrib><creatorcontrib>de Arriba, Felipe</creatorcontrib><creatorcontrib>Hernandez, Jose Mariano</creatorcontrib><creatorcontrib>Granell, Miquel</creatorcontrib><creatorcontrib>Peñalver, Francisco Javier</creatorcontrib><creatorcontrib>Garcia-Sanz, Ramon</creatorcontrib><creatorcontrib>Besalduch, Juan</creatorcontrib><creatorcontrib>Gonzalez, Yolanda</creatorcontrib><creatorcontrib>Martinez, Rafael Benigno</creatorcontrib><creatorcontrib>Hernandez, Miguel Teodoro</creatorcontrib><creatorcontrib>Gutierrez, Norma C</creatorcontrib><creatorcontrib>Puerta, Paloma</creatorcontrib><creatorcontrib>Valeri, Antonio</creatorcontrib><creatorcontrib>Paiva, Bruno</creatorcontrib><creatorcontrib>Blade, Joan</creatorcontrib><creatorcontrib>Mateos, Maria-Victoria</creatorcontrib><creatorcontrib>San Miguel, Jesus</creatorcontrib><creatorcontrib>Lahuerta, Juan Jose</creatorcontrib><creatorcontrib>Martinez-Lopez, Joaquin</creatorcontrib><creatorcontrib>GEM (Grupo Español de MM)/PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) Cooperative Study Group</creatorcontrib><creatorcontrib>on behalf of the GEM (Grupo Español de MM)/PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) Cooperative Study Group</creatorcontrib><title>Prognostic utility of serum free light chain ratios and heavy-light chain ratios in multiple myeloma in three PETHEMA/GEM phase III clinical trials</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>We investigated the prognostic impact and clinical utility of serum free light chains (sFLC) and serum heavy-light chains (sHLC) in patients with multiple myeloma treated according to the GEM2005MENOS65, GEM2005MAS65, and GEM2010MAS65 PETHEMA/GEM phase III clinical trials. Serum samples collected at diagnosis were retrospectively analyzed for sFLC (n = 623) and sHLC (n = 183). After induction or autologous transplantation, 309 and 89 samples respectively were available for sFLC and sHLC assays. At diagnosis, a highly abnormal (HA) sFLC ratio (sFLCr) (<0.03 or >32) was not associated with higher risk of progression. After therapy, persistence of involved-sFLC levels >100 mg/L implied worse survival (overall survival [OS], P = 0.03; progression-free survival [PFS], P = 0.007). Among patients that achieved a complete response, sFLCr normalization did not necessarily indicate a higher quality response. We conducted sHLC investigations for IgG and IgA MM. Absolute sHLC values were correlated with monoclonal protein levels measured with serum protein electrophoresis. At diagnosis, HA-sHLCrs (<0.29 or >73) showed a higher risk of progression (P = 0.006). Additionally, involved-sHLC levels >5 g/L after treatment were associated with shorter survival (OS, P = 0.001; PFS, P = 0.018). The HA-sHLCr could have prognostic value at diagnosis; absolute values of involved-sFLC >100 mg/L and involved-sHLC >5 g/L could have prognostic value after treatment.</description><subject>Analysis</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Autografts</subject><subject>Biochemistry</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Chains</subject><subject>Clinical trials</subject><subject>Clinical Trials, Phase III as Topic</subject><subject>Correlation analysis</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Electrophoresis</subject><subject>Hematology</subject><subject>Humans</subject><subject>Immunoglobulin A</subject><subject>Immunoglobulin G</subject><subject>Immunoglobulin Heavy Chains - blood</subject><subject>Immunoglobulin Light Chains - blood</subject><subject>Immunoglobulins</subject><subject>Induction Chemotherapy</subject><subject>Kaplan-Meier Estimate</subject><subject>Leukemia</subject><subject>Light</subject><subject>Light chains</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Multiple myeloma</subject><subject>Multiple Myeloma - blood</subject><subject>Multiple Myeloma - therapy</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Proteins</subject><subject>Ratios</subject><subject>Research and analysis methods</subject><subject>Retrospective Studies</subject><subject>Stem Cell Transplantation - methods</subject><subject>Studies</subject><subject>Survival</subject><subject>Transplantation</subject><subject>Transplantation, Autologous</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1FvFCEQxzdGY2v1GxglMTH6cFdY2GV5Mbk0Z7tJmzZafSUsC7c07HIC23ifwy8s17s2d-YeDA8Dw2_-wDCTZW8RnCJM0emdG_0g7HTpBjWFOcSY5c-yY8RwPinT8vnO_Ch7FcIdhAWuyvJldoQhYnmFyHH258a7xeBCNBKM0VgTV8BpEJQfe6C9UsCaRReB7IQZgBfRuADE0IJOifvV5MBmmvWjjWZpFehXyrperH2xW4vdzG8v5lez0_P5FVh2IihQ1zWQ1gxGCguiN8KG19kLnYx6s7Un2Y-v89uzi8nl9Xl9NrucSIqqOCGsog1rS6Ep0lq0UpWqYVhWOVStZEWjWIFhVRWwaaloGkpFWRHSUNFiiFmJT7L3G92ldYFv8xl4jiCsSlgVLBH1hmiduONLb3rhV9wJwx8czi-48Cl1VnHdUkJgS4QmBcE0bxjREuVYI6VRUdKk9WV72tj06YJqiF7YPdH9ncF0fOHueYnyqiAkCXzaCnj3a1Qh8t4EqawVg3Ljw71RXtKK4YR--Ac9_LottRDpAWbQLp0r16J8VhSUMkTzPFHTA1QareqNTMWnTfLvBXzeC0hMVL_jQowh8Pr7t_9nr3_usx932FR_NnbB2VS1bgj7INmA0rsQvNJPSUaQr3vnMRt83Tt82zsp7N3uBz0FPTYL_gsZqRT9</recordid><startdate>20180907</startdate><enddate>20180907</enddate><creator>Lopez-Anglada, 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utility of serum free light chain ratios and heavy-light chain ratios in multiple myeloma in three PETHEMA/GEM phase III clinical trials</title><author>Lopez-Anglada, Lucia ; Cueto-Felgueroso, Cecilia ; Rosiñol, Laura ; Oriol, Albert ; Teruel, Ana Isabel ; Lopez de la Guia, Ana ; Bengoechea, Enrique ; Palomera, Luis ; de Arriba, Felipe ; Hernandez, Jose Mariano ; Granell, Miquel ; Peñalver, Francisco Javier ; Garcia-Sanz, Ramon ; Besalduch, Juan ; Gonzalez, Yolanda ; Martinez, Rafael Benigno ; Hernandez, Miguel Teodoro ; Gutierrez, Norma C ; Puerta, Paloma ; Valeri, Antonio ; Paiva, Bruno ; Blade, Joan ; Mateos, Maria-Victoria ; San Miguel, Jesus ; Lahuerta, Juan Jose ; Martinez-Lopez, Joaquin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c718t-4987b9d6af71ffadce6eb93c820edc95be95308850bd7abb77a6844b7ad303963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Analysis</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Autografts</topic><topic>Biochemistry</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Chains</topic><topic>Clinical trials</topic><topic>Clinical Trials, Phase III as Topic</topic><topic>Correlation analysis</topic><topic>Development and progression</topic><topic>Diagnosis</topic><topic>Electrophoresis</topic><topic>Hematology</topic><topic>Humans</topic><topic>Immunoglobulin A</topic><topic>Immunoglobulin G</topic><topic>Immunoglobulin Heavy Chains - blood</topic><topic>Immunoglobulin Light Chains - blood</topic><topic>Immunoglobulins</topic><topic>Induction Chemotherapy</topic><topic>Kaplan-Meier Estimate</topic><topic>Leukemia</topic><topic>Light</topic><topic>Light chains</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Multiple myeloma</topic><topic>Multiple Myeloma - blood</topic><topic>Multiple Myeloma - therapy</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Proteins</topic><topic>Ratios</topic><topic>Research and analysis methods</topic><topic>Retrospective Studies</topic><topic>Stem Cell Transplantation - methods</topic><topic>Studies</topic><topic>Survival</topic><topic>Transplantation</topic><topic>Transplantation, Autologous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lopez-Anglada, Lucia</creatorcontrib><creatorcontrib>Cueto-Felgueroso, Cecilia</creatorcontrib><creatorcontrib>Rosiñol, Laura</creatorcontrib><creatorcontrib>Oriol, Albert</creatorcontrib><creatorcontrib>Teruel, Ana 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Jesus</creatorcontrib><creatorcontrib>Lahuerta, Juan Jose</creatorcontrib><creatorcontrib>Martinez-Lopez, Joaquin</creatorcontrib><creatorcontrib>GEM (Grupo Español de MM)/PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) Cooperative Study Group</creatorcontrib><creatorcontrib>on behalf of the GEM (Grupo Español de MM)/PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) Cooperative Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology 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C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lopez-Anglada, Lucia</au><au>Cueto-Felgueroso, Cecilia</au><au>Rosiñol, Laura</au><au>Oriol, Albert</au><au>Teruel, Ana Isabel</au><au>Lopez de la Guia, Ana</au><au>Bengoechea, Enrique</au><au>Palomera, Luis</au><au>de Arriba, Felipe</au><au>Hernandez, Jose Mariano</au><au>Granell, Miquel</au><au>Peñalver, Francisco Javier</au><au>Garcia-Sanz, Ramon</au><au>Besalduch, Juan</au><au>Gonzalez, Yolanda</au><au>Martinez, Rafael Benigno</au><au>Hernandez, Miguel Teodoro</au><au>Gutierrez, Norma C</au><au>Puerta, Paloma</au><au>Valeri, Antonio</au><au>Paiva, Bruno</au><au>Blade, Joan</au><au>Mateos, Maria-Victoria</au><au>San Miguel, Jesus</au><au>Lahuerta, Juan Jose</au><au>Martinez-Lopez, Joaquin</au><aucorp>GEM (Grupo Español de MM)/PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) Cooperative Study Group</aucorp><aucorp>on behalf of the GEM (Grupo Español de MM)/PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) Cooperative Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic utility of serum free light chain ratios and heavy-light chain ratios in multiple myeloma in three PETHEMA/GEM phase III clinical trials</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-09-07</date><risdate>2018</risdate><volume>13</volume><issue>9</issue><spage>e0203392</spage><epage>e0203392</epage><pages>e0203392-e0203392</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>We investigated the prognostic impact and clinical utility of serum free light chains (sFLC) and serum heavy-light chains (sHLC) in patients with multiple myeloma treated according to the GEM2005MENOS65, GEM2005MAS65, and GEM2010MAS65 PETHEMA/GEM phase III clinical trials. Serum samples collected at diagnosis were retrospectively analyzed for sFLC (n = 623) and sHLC (n = 183). After induction or autologous transplantation, 309 and 89 samples respectively were available for sFLC and sHLC assays. At diagnosis, a highly abnormal (HA) sFLC ratio (sFLCr) (<0.03 or >32) was not associated with higher risk of progression. After therapy, persistence of involved-sFLC levels >100 mg/L implied worse survival (overall survival [OS], P = 0.03; progression-free survival [PFS], P = 0.007). Among patients that achieved a complete response, sFLCr normalization did not necessarily indicate a higher quality response. We conducted sHLC investigations for IgG and IgA MM. Absolute sHLC values were correlated with monoclonal protein levels measured with serum protein electrophoresis. At diagnosis, HA-sHLCrs (<0.29 or >73) showed a higher risk of progression (P = 0.006). Additionally, involved-sHLC levels >5 g/L after treatment were associated with shorter survival (OS, P = 0.001; PFS, P = 0.018). The HA-sHLCr could have prognostic value at diagnosis; absolute values of involved-sFLC >100 mg/L and involved-sHLC >5 g/L could have prognostic value after treatment.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30192814</pmid><doi>10.1371/journal.pone.0203392</doi><tpages>e0203392</tpages><orcidid>https://orcid.org/0000-0003-1727-8546</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2018-09, Vol.13 (9), p.e0203392-e0203392 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2100860859 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Analysis Antineoplastic Combined Chemotherapy Protocols - therapeutic use Autografts Biochemistry Biology and Life Sciences Care and treatment Chains Clinical trials Clinical Trials, Phase III as Topic Correlation analysis Development and progression Diagnosis Electrophoresis Hematology Humans Immunoglobulin A Immunoglobulin G Immunoglobulin Heavy Chains - blood Immunoglobulin Light Chains - blood Immunoglobulins Induction Chemotherapy Kaplan-Meier Estimate Leukemia Light Light chains Medical prognosis Medical research Medicine and Health Sciences Multiple myeloma Multiple Myeloma - blood Multiple Myeloma - therapy Patients Prognosis Proteins Ratios Research and analysis methods Retrospective Studies Stem Cell Transplantation - methods Studies Survival Transplantation Transplantation, Autologous |
| title | Prognostic utility of serum free light chain ratios and heavy-light chain ratios in multiple myeloma in three PETHEMA/GEM phase III clinical trials |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T14%3A54%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prognostic%20utility%20of%20serum%20free%20light%20chain%20ratios%20and%20heavy-light%20chain%20ratios%20in%20multiple%20myeloma%20in%20three%20PETHEMA/GEM%20phase%20III%20clinical%20trials&rft.jtitle=PloS%20one&rft.au=Lopez-Anglada,%20Lucia&rft.aucorp=GEM%20(Grupo%20Espa%C3%B1ol%20de%20MM)/PETHEMA%20(Programa%20para%20el%20Estudio%20de%20la%20Terap%C3%A9utica%20en%20Hemopat%C3%ADas%20Malignas)%20Cooperative%20Study%20Group&rft.date=2018-09-07&rft.volume=13&rft.issue=9&rft.spage=e0203392&rft.epage=e0203392&rft.pages=e0203392-e0203392&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0203392&rft_dat=%3Cgale_plos_%3EA557791722%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2100860859&rft_id=info:pmid/30192814&rft_galeid=A557791722&rft_doaj_id=oai_doaj_org_article_fd7440d4af454372b94fc123f1ef1567&rfr_iscdi=true |