![]() ![]() Neoplastic plasma cells can secrete monoclonal immunoglobulins which are monitored and used as surrogate markers of disease activity. Multiple myeloma (MM) is an incurable malignancy arising from plasma cells. The qIgA response criteria more accurately stratify patients based on the progression risk and may detect disease progression earlier, which may lead to more consistent measurement of trial endpoints and improved patient outcomes. In conclusion, monitoring IgA MM using MCP-based IMWG criteria may be falsely reassuring, given that MCP levels on SPEP decrease faster than qIgA levels. There was a consistent trend toward earlier detection of disease progression using qIgA versus IMWG progression criteria. Stratification by qIgA criteria, unlike IMWG criteria, led to clear separation of the progression-free survival curves of patients achieving a PR or very good PR. The median time to achieve a partial response (PR) was shorter using standard IMWG versus qIgA response criteria (32 vs 58 days, pā<ā0.001). The SPEP MCP nadir occurred a median of 41 (IQR 0ā102) days before the qIgA. We retrospectively studied disease response kinetics using qIgA versus MCPs by SPEP, and developed and validated novel qIgA disease assessment criteria in 491 IgA MM patients. The utility of nephelometric quantitative IgA (qIgA) to monitor IgA multiple myeloma (MM) is unclear. Unlike IgG monoclonal proteins (MCPs), IgA MCP quantification is unreliable due to beta-migration of IgA MCPs on serum protein electrophoresis (SPEP). Leukemia volume 35, pages 1428ā1437 ( 2021) Cite this article ![]() ![]() MULTIPLE MYELOMA GAMMOPATHIES Disease monitoring with quantitative serum IgA levels provides a more reliable response assessment in multiple myeloma patients ![]()
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