文章：

高灵敏度检测多发性骨髓瘤sCR患者血液中的M蛋白

High sensitivity blood-based M-protein detection in sCR patients with multiple myeloma

原文发布日期：2017-08-25

DOI: 10.1038/bcj.2017.75

类型: Original Article

开放获取: 是

英文摘要：

We assessed the ability of a mass spectrometry-based technique, called monoclonal immunoglobulin rapid accurate mass measurement (miRAMM), to extend the analytical range of M-protein detection in serum samples obtained from myeloma patients in stringent complete response (sCR) post-autologous stem cell transplant (ASCT). To aid the M-protein detection post ASCT, the accurate molecular mass of the M-protein light chain at diagnosis was determined in all patients (N=30) and used to positively identify clones in the sCR serum. Day 100 post-ASCT, sCR samples had miRAMM identifiable M-proteins in 81% of patients. Patients who had achieved only a partial remission (PR) pre-ASCT and those with IgG isotypes serum samples had the highest rate of M-protein detection by miRAMM. miRAMM positivity at single time points (day 100, 6 months or 12 months) did not correlate with progression-free survival (PFS). In contrast, sCR patients who did not decrease their miRAMM M-protein intensities in serial measurements had shorter PFS than those whose miRAMM intensities decreased (median 17.9 months vs 51.6 months; P<0.0017). miRAMM M-protein is a more sensitive blood-based test than traditional M-protein tests and could cost effectively aid in serially monitoring complete remission for continue response or biochemical relapse.

摘要翻译： 

我们评估了一种基于质谱分析的技术——单克隆免疫球蛋白快速精确质量测定（miRAMM）在扩展多发性骨髓瘤患者自体干细胞移植（ASCT）后达到严格完全缓解（sCR）的血清样本中M蛋白检测分析范围的能力。为辅助ASCT后的M蛋白检测，我们测定了所有患者（N=30）确诊时M蛋白轻链的精确分子质量，并用于在sCR血清中阳性鉴定克隆。ASCT后第100天，81%患者的sCR样本中通过miRAMM可识别到M蛋白。移植前仅达到部分缓解（PR）的患者及IgG同种型血清样本的患者通过miRAMM检测到M蛋白的比例最高。单个时间点（第100天、6个月或12个月）的miRAMM阳性结果与无进展生存期（PFS）无关。相比之下，在连续检测中miRAMM M蛋白强度未降低的sCR患者，其PFS短于miRAMM强度降低的患者（中位时间17.9个月 vs 51.6个月；P<0.0017）。miRAMM M蛋白检测是一种比传统M蛋白检测更敏感的血液检测方法，能够以经济高效的方式辅助连续监测完全缓解患者的持续应答或生化复发。

原文链接：

High sensitivity blood-based M-protein detection in sCR patients with multiple myeloma