Biological Differences, Yet Comparable Outcomes: A Retrospective Study on the Impact of Treatment Strategy on Light Chain vs. Intact Immunoglobulin Myeloma.

To compare baseline characteristics and survival patterns between heavy and light chain subtypes of multiple myeloma in Indian patients, and to evaluate the impact of treatment choices on patient outcomes. Electronic health records of 578 MM patients treated between January 2013 and May 2023 were reviewed. After exclusions, 316 newly diagnosed MM patients were analyzed and categorized into Group 1 (Intact Immunoglobulin Myeloma, (IIM), n = 249) and Group 2 (Light Chain Myeloma, (LCM), n = 67). Baseline characteristics and survival outcomes were compared between the groups. Most of the baseline patient characteristics were comparable between the predefined groups; however, LCM patients had significantly higher serum creatinine, β2-microglobulin, and kappa/lambda ratios, along with lower serum albumin levels. They were also younger and presented with ISS stage III disease. LCM patients receiving VCD as an induction regimen showed poorer responses compared to those on VRD, and a higher proportion of LCM patients received doublet regimens as maintenance therapy. Kaplan-Meier analysis revealed no significant differences in progression-free survival (PFS) or overall survival (OS) between IIM and LCM groups.The selection of therapy based on disease severity at the time of diagnosis plays a critical role in determining outcomes for patients with MM.