{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:36:53Z","timestamp":1789011413967,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,2,22]],"date-time":"2016-02-22T00:00:00Z","timestamp":1456099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Wilhelminen Cancer Research Institute"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:p>Heavy light chain (HLC) assays allow precise measurement of the monoclonal and of the noninvolved polyclonal immunoglobulins of the same isotype as the M\u2010protein (e.g., monoclonal IgA\u03ba and polyclonal IgA\u03bb in case of an IgA\u03ba myeloma), which was not possible before. The noninvolved polyclonal immunoglobulin is termed \u2018HLC\u2010matched pair\u2019. We investigated the impact of the suppression of the HLC\u2010matched pair on outcome in 203 patients with multiple myeloma, a phenomenon that likely reflects the host's attempt to control the myeloma clone. Severe (&gt;50%) HLC\u2010matched pair suppression was identified in 54.5% of the 156 newly diagnosed patients and was associated with significantly shorter survival (45.4 vs. 71.9\u00a0months,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.019). This correlation was statistically significant in IgG patients (46.4 vs. 105.1\u00a0months,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.017), but not in patients with IgA myelomas (32.9 vs. 54.1\u00a0months,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.498). At best response, HLC\u2010matched pair suppression improved only in patients with \u2265VGPR, indicating partial or complete humoral immune reconstitution during remission in those with excellent response. Severe HLC\u2010matched pair suppression retained its prognostic impact also during follow\u2010up after first response. In the 47 pretreated patients with relapsed\/refractory disease, a similar correlation between severe HLC suppression and survival was noted (22.8 vs. not reached,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.028). Suppression of the polyclonal immunoglobulins of the other isotypes than the myeloma protein correlated neither with HLC\u2010matched pair suppression, nor with outcome. Multivariate analysis identified severe HLC\u2010matched pair suppression as independent risk factor for shorter survival, highlighting the impact of isotype specific immune dysregulation on outcome in multiple myeloma. Am. J. Hematol. 91:295\u2013301, 2016. \u00a9 2015 The Authors. American Journal of Hematology Published by Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.24268","type":"journal-article","created":{"date-parts":[[2015,12,11]],"date-time":"2015-12-11T00:55:21Z","timestamp":1449795321000},"page":"295-301","source":"Crossref","is-referenced-by-count":38,"title":["Suppression of the noninvolved pair of the myeloma isotype correlates with poor survival in newly diagnosed and relapsed\/refractory patients with myeloma"],"prefix":"10.1002","volume":"91","author":[{"given":"Heinz","family":"Ludwig","sequence":"first","affiliation":[{"name":"Wilhelminen Cancer Research Institute, C\/O Department of Medicine I Center of Oncology, Hematology with Outpatient Department and Palliative Care, Wilheminenhospital Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dejan","family":"Milosavljevic","sequence":"additional","affiliation":[{"name":"FH Campus Vienna, University of Applied Sciences Vienna 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