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Article Abstract
Clonal isotype switch (CIS) in multiple myeloma (MM) refers to the emergence of new immunoglobulin bands distinct from those present at diagnosis. CIS often appears after high-dose chemotherapy and autologous stem cell transplantation (ASCT), reflecting post-transplant immune recovery. However, its prognostic significance remains unclear. In this study, CIS was observed (CIS-positive) in 31.7 % (26/82) of patients undergoing ASCT. Patients receiving bortezomib-containing induction therapy showed a higher prevalence of CIS compared to those treated with vincristine-doxorubicin-dexamethasone chemotherapy (37.9 % vs. 16.7 %, p = 0.061). Median overall survival (OS) was not estimable (NE) in the CIS-positive group, while it was 47 months in the CIS-negative group (hazard ratio [HR]: 0.27, 95 % CI: 0.11-0.67; p = 0.005). Median progression-free survival (PFS) was also NE in the CIS-positive group versus 26 months in the CIS-negative group (HR: 0.25, 95 % CI: 0.11-0.58; p = 0.001). These findings suggest that CIS is an independent biomarker associated with favorable outcomes in MM patients undergoing ASCT.
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| http://dx.doi.org/10.1016/j.leukres.2025.107641 | DOI Listing |
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