{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T20:02:23Z","timestamp":1766088143145,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T00:00:00Z","timestamp":1694304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006436","name":"Celgene","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006436","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Previous studies suggest that postautologous stem cell transplant (ASCT) recovery of polyclonal immunoglobulin from immunoparesis in patients with multiple myeloma is a positive prognostic marker. We performed a longitudinal analysis of polyclonal immunoglobulin concentrations and unique B\u2010cell sequences in patients enrolled in the phase 3 ATLAS trial that randomized 180 subjects to either carfilzomib, lenalidomide, dexamethasone (KRd) or lenalidomide (R) maintenance. In the KRd arm, standard\u2010risk patients with minimal residual disease negativity after six cycles de\u2010escalated to R alone after cycle 8. One year from the initiation of maintenance at least partial recovery of polyclonal immunoglobulin was observed in more patients on the R arm (58\/66, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and in those who de\u2010escalated from KRd to R (27\/38, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) compared to the KRd arm (9\/36). In patients who switched from KRd to R, the concentrations of uninvolved immunoglobulin and the number of B\u2010cell unique sequences increased over time, approaching values observed in the R arm. There were no differences in progression\u2010free survival between the patients with at least partial immunoglobulin recovery and the remaining population. Our analysis indicates that patients receiving continuous therapy after ASCT experience prolonged immunoparesis, limiting prognostic significance of polyclonal immunoglobulin recovery in this setting.<\/jats:p>","DOI":"10.1111\/bjh.19097","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T02:30:36Z","timestamp":1694399436000},"page":"792-802","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Polyclonal immunoglobulin recovery in patients with newly diagnosed myeloma receiving maintenance therapy after autologous haematopoietic stem cell transplantation with either carfilzomib, lenalidomide and dexamethasone or lenalidomide alone: Subanalysis of the randomized phase 3 <scp>ATLAS<\/scp> trial"],"prefix":"10.1111","volume":"203","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7588-1453","authenticated-orcid":false,"given":"Tadeusz","family":"Kubicki","sequence":"first","affiliation":[{"name":"University of Chicago  Chicago Illinois USA"},{"name":"Pozna\u0144 University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0855-6591","authenticated-orcid":false,"given":"Dominik","family":"Dytfeld","sequence":"additional","affiliation":[{"name":"Pozna\u0144 University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6612-3535","authenticated-orcid":false,"given":"Tomasz","family":"Wr\u00f3bel","sequence":"additional","affiliation":[{"name":"Wroc\u0142aw Medical University  Wroc\u0142aw 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