ΔΙΑΓΝΩΣΤΙΚΗ ΠΡΟΣΕΓΓΙΣΗ ΠΛΑΣΜΑΤΟΚΥΤΤΑΡΙΚΩΝ ΔΥΣΚΡΑΣΙΩΝ

1. ΔΙΑΓΝΩΣΤΙΚΗ ΠΡΟΣΕΓΓΙΣΗ ΠΛΑΣΜΑΤΟΚΥΤΤΑΡΙΚΩΝ ΔΥΣΚΡΑΣΙΩΝ

42. INTERNATIONAL PROGNOSTIC STAGING SYSTEM ( ISS) ΣΤΑΔΙΟ 1)β 2 μικροσφαιρίνη 2)Αλβουμίνη ΕΠΙΒΙΩΣΗ Ι β 2 μ<3,5 mg/L A λβ >3,5g/dL 62 μήνες ΙΙ Ενδιάμεσες τιμές 44 μήνες ΙΙΙ β 2 μ>5,5 mg/L 29 μήνες

51. 0 1000 2000 3000 4000 5000 6000 7000 0.0 0.2 0.4 0.6 0.8 1.0 Cumulative survival probability Figure 11.3. Kaplan-Meier plot of survival in 43 patients with asymptomatic MM with and without abnormal  /  ratios. 6

58.  FLC (mg/L)  FLC (mg/L)  FLC (mg/L) Figure 19.2. Serum FLCs in 32 patients with MGUS. 12

59. Years Percent 0 10 20 30 40 50 60 0 5 10 15 20 25 30 Normal FLC ratio (  0.26-1.65) Abnormal FLC ratio (  <0.26 or > 1.65) Figure 19.3. Risk of progression based upon MGUS type, its quantity above or below 15 g /L and the presence or absence of an abnormal FLC  /  ratio. 15

60. Table 19.1. Risk stratification model to predict progression of MGUS.

61. Figure 19.5. Risk of progression to myeloma or related condition in 1148 patients with MGUS. 15

65. ΠΡΩΤΟΠΑΘΗΣ ΑΝΟΣΟΚΥΤΤΑΡΙΚΗ ΑΜΥΛΟΕΙΔΩΣΗ

70. IFE sensitivity SPE sensitivity  FLC (mg/L)  FLC (mg/L) Figure 15.8. Serum free light chains in 262 patients with AL amyloidosis at diagnosis, 282 normal sera, 224 patients with light chain multiple myeloma and 28 patients with nonsecretory myeloma.

71. Probability of survival Serum FLC suppressed by > 50% Serum FLC suppressed by < 50% No FLC suppression Probability of survival 0 24 48 72 96 120 0 0.2 0.8 0.6 0.4 1.0 Months since diagnosis Figure 15.15. Kaplan-Meier probability of survival in 137 patients with AL amyloidosis showing that a reduction of sFLCs by greater than 50% following chemotherapy was associated with increased survival. (Courtesy of PN Hawkins).