Immunoglobulin A Subtype and Survival After Upfront Autologous Stem Cell Transplantation in Multiple Myeloma: A Real-World Cohort from the Bortezomib Era.
4 affiliations
- 1Department of Hematology, Bursa Şehir Training & Research Hospital, University of Health Sciences, 16250 Bursa, Türkiye.
- 2Department of Internal Medicine, Bursa Şehir Training & Research Hospital, University of Health Sciences, 16250 Bursa, Türkiye.
- 3Department of Hematology, Ali Osman Sönmez Oncology Hospital, 16020 Bursa, Türkiye.
- 4Department of Hematology, Bursa Uludağ University Hospital, Bursa Uludağ University, 16059 Bursa, Türkiye.
Abstract
Background
Immunoglobulin isotype is recorded at diagnosis in every patient with intact-immunoglobulin multiple myeloma, but is not retained in the ISS, R-ISS, or R2-ISS.Methods
We analyzed 196 consecutive patients with IgA or IgG myeloma who underwent upfront autologous stem cell transplantation at a single center (2009-2023). The primary endpoint was progression-free survival (PFS); overall survival (OS) was the secondary endpoint. Cox models used information available at transplantation, including the induction regimen and transplant year, in the complete-case set (n = 131) and after multiple imputation (n = 196).Results
Median PFS was 14.8 versus 30.5 months and OS 43.2 versus 94.2 months in IgA versus IgG patients (both p < 0.001). IgA isotype was associated with inferior PFS (adjusted HR 1.85, 95% CI 1.13-3.02; imputed HR 1.83, 95% CI 1.22-2.73). For OS, the HR was 1.68 (0.98-2.88) in the complete-case analysis and 1.91 (1.24-2.94) after imputation, so its magnitude is uncertain. Models with maintenance gave 1.87 and 1.82. Progression documentation differed by maintenance status. Cytogenetic data were too incomplete to assess independence from genomic risk.Conclusions
In a bortezomib-era transplant cohort, IgA isotype was associated with inferior PFS; the association with OS was of uncertain magnitude. The finding is hypothesis-generating and requires validation in cohorts with complete cytogenetic characterization.
Related
- Healthcare resource utilisation and costs of chemotherapy and autologous haemopoietic cell transplantation of patients with multiple myeloma in China: a multi-centre retrospective analysis
- Real-world analysis of thromboprophylaxis use during autologous hematopoietic stem cell transplantation for multiple myeloma
- Prognostic Impact of EASIX According to the Timing of Assessment in Newly Diagnosed Multiple Myeloma Undergoing Autologous Stem Cell Transplantation
- Oral versus intravenous melphalan for autologous stem cell transplantation conditioning in lymphoma and multiple myeloma: a retrospective cohort study
- Associations of Baseline Cognitive and Psychosocial Function with Clinical Outcomes After Autologous Stem Cell Transplantation in a Multiple Myeloma Sample
BibTeX
@article{koca2026immunoglobulin,
title = {{Immunoglobulin A Subtype and Survival After Upfront Autologous Stem Cell Transplantation in Multiple Myeloma: A Real-World Cohort from the Bortezomib Era.}},
author = {Tuba Güllü Koca and Nizameddin Koca and Fazıl Çağrı Hunutlu and Ahmet Mert Yanık and Sinem Çubukçu and Rümeysa Yılmaz and Tuba Ersal and Vildan Gürsoy and İbrahim Ethem Pınar and Vildan Özkocaman and Fahir Özkalemkaş},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18193178},
url = {https://europepmc.org/article/MED/42882872},
note = {CC BY},
}
RIS
TY - JOUR
TI - Immunoglobulin A Subtype and Survival After Upfront Autologous Stem Cell Transplantation in Multiple Myeloma: A Real-World Cohort from the Bortezomib Era.
AU - Tuba Güllü Koca
AU - Nizameddin Koca
AU - Fazıl Çağrı Hunutlu
AU - Ahmet Mert Yanık
AU - Sinem Çubukçu
AU - Rümeysa Yılmaz
AU - Tuba Ersal
AU - Vildan Gürsoy
AU - İbrahim Ethem Pınar
AU - Vildan Özkocaman
AU - Fahir Özkalemkaş
PY - 2026
DA - 2026/10/02
JO - Cancers
DO - 10.3390/cancers18193178
UR - https://europepmc.org/article/MED/42882872
AB - Background Immunoglobulin isotype is recorded at diagnosis in every patient with intact-immunoglobulin multiple myeloma, but is not retained in the ISS, R-ISS, or R2-ISS.Methods We analyzed 196 consecutive patients with IgA or IgG myeloma who underwent upfront autologous stem cell transplantation at a single center (2009-2023). The primary endpoint was progression-free survival (PFS); overall survival (OS) was the secondary endpoint. Cox models used information available at transplantation, including the induction regimen and transplant year, in the complete-case set (n = 131) and after multiple imputation (n = 196).Results Median PFS was 14.8 versus 30.5 months and OS 43.2 versus 94.2 months in IgA versus IgG patients (both p < 0.001). IgA isotype was associated with inferior PFS (adjusted HR 1.85, 95% CI 1.13-3.02; imputed HR 1.83, 95% CI 1.22-2.73). For OS, the HR was 1.68 (0.98-2.88) in the complete-case analysis and 1.91 (1.24-2.94) after imputation, so its magnitude is uncertain. Models with maintenance gave 1.87 and 1.82. Progression documentation differed by maintenance status. Cytogenetic data were too incomplete to assess independence from genomic risk.Conclusions In a bortezomib-era transplant cohort, IgA isotype was associated with inferior PFS; the association with OS was of uncertain magnitude. The finding is hypothesis-generating and requires validation in cohorts with complete cytogenetic characterization.
SN - 2072-6694
ER -