[Ian]

Study: Biclonal & monoclonal myeloma survival is similar

by Ian on Sun Aug 20, 2017 2:47 am

Since the topic of biclonal gammopathy comes up now and then here in the forum, I thought I would share the abstract for a study that was published recently.

Recall that a patient with biclonal multiple myeloma is one that has two types of paraprotein (or two "M-spikes"), rather than the more common single M-spike. The immunofixation results for someone with biclonal gammopathy might report, for example, that IgA kappa and IgG lambda paraproteins were detected, rather than just, say, IgG lambda paraprotein.

The authors of the new study, who are from a number of different cancer centers in Europe and the United States, created two samples of patients. The first sample had patients with biclonal myeloma. The second sample was one that the researchers created by looking for patients in their records with one M-spike (monoclonal myeloma), and who were similar in terms of age, gender, and other characteristics to the biclonal patients in the first sample.

The researchers then compared survival outcomes for the two groups of patients. They found that there was not a statistically significant difference in survival between the two groups.

Here's the study reference:

Jurczyszyn, A, et al, "Similar survival outcomes in patients with biclonal versus monoclonal myeloma: a multi-institutional matched case-control study," Annals of Hematology, August 2017 (abstract)

Here's the abstract:

Multiple myeloma is a plasma cell malignancy characterized by clonal proliferation of plasma cells in the bone marrow and associated organ damage. Usually, patients with myeloma present with a single monoclonal protein in serum and/or urine constituted by one heavy chain and one light chain. In less than 5% of the patients, more than one monoclonal protein can be identified. The aim of our retrospective multicenter matched case-control study was to describe the characteristics of cases with biclonal myeloma and compare them against a control group of monoclonal myeloma patients matched by age, sex, and year of diagnosis. A total of 50 previously untreated cases with biclonal myeloma and 50 matched controls with monoclonal myeloma were included in this study. The controls were matched (1:1) for age, sex, year of diagnosis, and participating center. There were no differences in the rates of anemia (52 vs. 59%; p = 0.52), renal dysfunction (36 vs. 34%; p = 0.83), hypercalcemia (9 vs. 16%; p = 0.28), or presence of lytic lesions (23 vs. 16%; p = 0.38) between groups. Similarly, there was no difference in the rates of overall response to therapy (85 vs. 90%; p = 0.88) or survival rates of cases with biclonal myeloma and controls with monoclonal myeloma (4-year survival 72 vs. 76%; p = 0.23). Results of our study suggest that patients with biclonal myeloma have similar response and survival rates than patients with monoclonal myeloma.

Cheers!

[f cancer]

Re: Study: Biclonal & monoclonal myeloma survival is similar

by f cancer on Tue Aug 22, 2017 9:39 am

Thanks for the update. I have biclonal and was told by my doctor that I am not at an increased risk, but it's good to see it in writing.

[Solstice]

Re: Study: Biclonal & monoclonal myeloma survival is similar

by Solstice on Thu Aug 24, 2017 9:21 am

Thank you for posting this information!

[paul54]

Re: Study: Biclonal & monoclonal myeloma survival is similar

by paul54 on Sun Sep 10, 2017 10:49 pm

Thanks for the information.

I was diagnosed with biclonal multiple myeloma in July 2017 after 2 months misdiagnosis. The oncologist is watching my IgG and IgA levels. I am being treating with Velcade and thalidomide, sometimes with steroids. I am going in tomorrow for my 6th shot of Velcade.

I feel very pessimistic and lousy. I think of suicide frequently. I guess I just can't handle the pain and news that I will not make it to 60 years old. I will be 54 in a couple of weeks. At least your article brings some comfort to me.

Thanks,
Paul

[kshornb]

Re: Study: Biclonal & monoclonal myeloma survival is similar

by kshornb on Mon Sep 11, 2017 10:05 am

Paul:

I was 53 when I was diagnosed with lambda light chain myeloma with 13(q) deletion. I think your feelings are very common, you have been dealt a horrible blow, and I believe that if most of us were completely honest, we would admit that the thought had crossed our minds at some point. Most people are just too scared to admit it. I know what helps me is the thought of all the people I love, and all the things I still want to do with them. I understand the feeling of frustration of not knowing if you will ever feel well enough to do those things with them, but please know that things will get better. I can't say that the pain will go away completely, it does for some but not for others.

My pain has been constant, but my doctors have worked very hard with me to reduce it significantly, so that I can live a relatively "normal" life. I will probably never again be able to work out 5 days a week, ride horses, go for long hikes in the mountains. But there are a lot of people on this forum that still can do those things, and more. Everyone with this disease is different, just make sure to talk to your doctor, tell them everything, and don't ever "sugar coat" your symptoms. I am sure they will do their best to make your quality of life as good as they possibly can.

Please take care, and know that you are never alone.

Kathleen