A Retrospective Cohort Study Comparing Clinical Outcomes in Multiple Myeloma Patients Treated with Bortezomib, Lenalidomide, and Dexamethasone (VRD) based on Kappa vs. Lambda Light Chains and IgA vs. IgG Subtypes at a Private Tertiary Hospital
Multiple myeloma is a malignancy characterized by the proliferation of clonal plasma cells, resulting in diverse clinical and biochemical manifestations. This study aimed to assess the association between immunoglobulin subtypes and treatment outcomes in multiple myeloma patients. The role of immunoglobulin subtypes in influencing treatment outcomes remains unclear, necessitating further investigation.
Materials and Methods/Case Presentation/Objective:
A retrospective cohort study was conducted involving 55 patients diagnosed with multiple myeloma and treated from 2018 to 2022. Clinical, biochemical, and demographic data were analyzed. Multinomial logistic regression and Ch-square analysis assessed the associations between immunoglobulin subtypes and clinical outcomes, adjusting for age and sex.
Results/Description/Main Outcome Measure(s):
Nearly half of the patients (49.09%) achieved complete response, indicating substantial disease control in this subgroup. Additionally, 27.27% of patients exhibited very good partial response, while 10.91% maintained stable disease. Persistent or progressive disease was observed in 10.91% of the cohort, and one patient (1.82%) expired during the observation period. Multinomial logistic regression revealed no significant associations between antibody subtypes (IgA vs. IgG or kappa vs. lambda) and clinical outcomes, suggesting that these subtypes may not be reliable prognostic markers. Despite kappa and IgG subtypes being predominant, their presence did not confer any advantage or disadvantage in terms of treatment efficacy. Limitations of the study include its retrospective nature, relatively small sample size, and the presence of missing data, which may have impacted the robustness of the statistical analyses.
Conclusion(s).:
Immunoglobulin subtypes may not independently predict clinical outcomes in multiple myeloma. This highlights the need for integrative prognostic models that incorporate genetic, molecular, and treatment-specific factors. Prospective multicenter studies and advanced molecular diagnostics are recommended to validate findings and guide personalized treatment strategies.
Trademarked Items:
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