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Blood：尿单克隆蛋白不是判定MM患者是否完全缓解的必要指标

2019-04-23 MedSci MedSci原创

单克隆蛋白血清尿液多发性骨髓瘤完全缓解
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中心点：经治疗后，sIFE转为阴性的多发性骨髓瘤患者，100%(确诊时仅血清M蛋白阳性）或98.6%（确诊时血清和尿液M蛋白均阳性）的为uIFE阴性。符合完全缓解标准单无uIFE检测结果的患者的预后与完全缓解的患者的预后相当，优于部分缓解患者的预后。摘要：多发性骨髓瘤（MM）的完全缓解（CR）的标准为免疫固定电泳血清（sIFE）和尿液（uIFE）单克隆蛋白（M-蛋白）均为阴性。但患者sIFE转阴性

中心点：

经治疗后，sIFE转为阴性的多发性骨髓瘤患者，100%(确诊时仅血清M蛋白阳性）或98.6%（确诊时血清和尿液M蛋白均阳性）的为uIFE阴性。

符合完全缓解标准单无uIFE检测结果的患者的预后与完全缓解的患者的预后相当，优于部分缓解患者的预后。

摘要：

多发性骨髓瘤（MM）的完全缓解（CR）的标准为免疫固定电泳血清（sIFE）和尿液（uIFE）单克隆蛋白（M-蛋白）均为阴性。但患者sIFE转阴性后uIFE并不一定也转为阴性。

Juan-José Lahuerta等研究人员对GEM2012MENOS65试验所治疗的384位MM患者（不包括只有轻链的患者）的M蛋白进行评估，以明确在治疗后sIFE转为阴性的患者uIFE仍为阳性的概率；同时评估完全缓解的、完全缓解但无uIFE信息的和非常好的部分缓解（VGPR）患者的微小残留病灶（MRD）阴性状态和无进展存活率。

在107位诊断为血清M蛋白阳性、治疗后转为sIFE阴性且有uIFE信息的患者中，uIFE阳性率为0%。在161位诊断时血清和尿液M蛋白均阳性、治疗后转为sIFE阴性的患者中，有3位（1.8%）仍为uIFE阳性。完全缓解的患者和完全缓解但无uIFE信息的患者，巩固治疗后的MRD率和2年内的无进展存活率均无明显差别，但VGPR患者的MRD率和无进展存活率均明显低于前两者。

综上所述，本研究提示uIFE对于MM患者（非仅轻链患者）判断是否完全缓解并不必要。

原始出处：

Juan-José Lahuerta，  et al.Role of urine immunofixation in the complete response assessment of MM patients other than light- chain-only disease. Blood 2019 ：blood.2019000671； doi： https：//doi.org/10.1182/blood.2019000671 

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    2020-01-10 aids221

    #克隆#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1660190, encodeId=09a6166019056, content=<a href='/topic/show?id=8d0d28912db' target=_blank style='color:#2F92EE;'>#克隆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28912, encryptionId=8d0d28912db, topicName=克隆)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=596825099872, createdName=aids221, createdTime=Fri Jan 10 04:39:00 CST 2020, time=2020-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1642463, encodeId=c3be1642463f1, content=<a href='/topic/show?id=842f458e61f' target=_blank style='color:#2F92EE;'>#完全缓解#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45876, encryptionId=842f458e61f, topicName=完全缓解)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b5d22942638, createdName=小小小向日葵, createdTime=Sun Jan 19 02:39:00 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365236, encodeId=9faa36523618, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Thu Apr 25 13:13:00 CST 2019, time=2019-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365206, encodeId=1c9d365206f4, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Wed Apr 24 23:46:33 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365205, encodeId=30b5365205e5, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Wed Apr 24 23:46:25 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365170, encodeId=fa833651e022, content=学习了！很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Apr 24 08:04:16 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365156, encodeId=dd3e36515634, content=学习学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Wed Apr 24 05:52:28 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365151, encodeId=d19336515153, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Tue Apr 23 22:29:47 CST 2019, time=2019-04-23, status=1, ipAttribution=)]
    2020-01-19 小小小向日葵

    #完全缓解#

    0

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    2019-04-25 王秀

    学习了，涨知识了！

    0

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    2019-04-24 王秀

    学习了，涨知识了！

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1660190, encodeId=09a6166019056, content=<a href='/topic/show?id=8d0d28912db' target=_blank style='color:#2F92EE;'>#克隆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28912, encryptionId=8d0d28912db, topicName=克隆)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=596825099872, createdName=aids221, createdTime=Fri Jan 10 04:39:00 CST 2020, time=2020-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1642463, encodeId=c3be1642463f1, content=<a href='/topic/show?id=842f458e61f' target=_blank style='color:#2F92EE;'>#完全缓解#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45876, encryptionId=842f458e61f, topicName=完全缓解)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b5d22942638, createdName=小小小向日葵, createdTime=Sun Jan 19 02:39:00 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365236, encodeId=9faa36523618, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Thu Apr 25 13:13:00 CST 2019, time=2019-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365206, encodeId=1c9d365206f4, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Wed Apr 24 23:46:33 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365205, encodeId=30b5365205e5, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Wed Apr 24 23:46:25 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365170, encodeId=fa833651e022, content=学习了！很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Apr 24 08:04:16 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365156, encodeId=dd3e36515634, content=学习学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Wed Apr 24 05:52:28 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365151, encodeId=d19336515153, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Tue Apr 23 22:29:47 CST 2019, time=2019-04-23, status=1, ipAttribution=)]
    2019-04-24 王秀

    学习了

    0

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    2019-04-24 飛歌

    学习了！很有用不错

    0

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    2019-04-24 深海的鱼

    学习学习学习学习

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1660190, encodeId=09a6166019056, content=<a href='/topic/show?id=8d0d28912db' target=_blank style='color:#2F92EE;'>#克隆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28912, encryptionId=8d0d28912db, topicName=克隆)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=596825099872, createdName=aids221, createdTime=Fri Jan 10 04:39:00 CST 2020, time=2020-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1642463, encodeId=c3be1642463f1, content=<a href='/topic/show?id=842f458e61f' target=_blank style='color:#2F92EE;'>#完全缓解#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45876, encryptionId=842f458e61f, topicName=完全缓解)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b5d22942638, createdName=小小小向日葵, createdTime=Sun Jan 19 02:39:00 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365236, encodeId=9faa36523618, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Thu Apr 25 13:13:00 CST 2019, time=2019-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365206, encodeId=1c9d365206f4, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Wed Apr 24 23:46:33 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365205, encodeId=30b5365205e5, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Wed Apr 24 23:46:25 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365170, encodeId=fa833651e022, content=学习了！很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Apr 24 08:04:16 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365156, encodeId=dd3e36515634, content=学习学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Wed Apr 24 05:52:28 CST 2019, time=2019-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=365151, encodeId=d19336515153, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Tue Apr 23 22:29:47 CST 2019, time=2019-04-23, status=1, ipAttribution=)]
    2019-04-23 王秀

    学习了，涨知识了！

    0

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