Light Chain Escape in 3 Cases: Evidence of Intraclonal Heterogeneity in Multiple Myeloma from a Single Institution in Poland

Figure 1

Disease course of patients with (a) biclonal MGUS progressing to LCMM (case ), (b) oligosecretory IgG MM (case ), and (c) IgA IIMM (case ). MGUS: monoclonal gammopathy of undetermined significance, LCMM: light chain multiple myeloma, MM: multiple myeloma, IIMM: intact immunoglobulin multiple myeloma, SPE: serum protein electrophoresis, dFLC: difference in concentration between involved and uninvolved free light chain measurement (Freelite), dHLC: difference in concentration between involved and uninvolved heavy/light chain measurement (Hevylite), MPS: methylprednisolone, CTD: cyclophosphamide, thalidomide, and dexamethasone, PAD: bortezomib, doxorubicin, and dexamethasone, VAD: vincristine, doxorubicin, and dexamethasone, CD: cyclophosphamide and dexamethasone, IR: ionising radiation, VCD: bortezomib, cyclophosphamide, and dexamethasone, and ASCT: autologous stem cell transplant; blue open circle indicates a normalised sFLC ratio, red open circle indicates a normalised HLC ratio, and green open circle indicates normalised sFLC and HLC ratio.

(a)

(b)

(c)