Viera Sandecká1, Roman Hájek2,3,4, Luděk Pour1, Ivan Špička5, Vlastimil Ščudla6, Evžen Gregora7, Jakub Radocha8, Lenka Walterová9, Petr Kessler10, Lenka Zahradová2, Dagmar Adamová11, Kamila Valentova12, Ivan Vonke13, Jarmila Obernauerová14, David Starostka15, Marek Wróbel16, Lucie Brožová17, Jiří Jarkovský17, Aneta Mikulášová4,18, Lucie Říhová19, Sabina Ševčíková3,19, Ján Straub5, Jiří Minařík6, Zdeněk Adam1, Marta Krejčí1, Zdeněk Král1, Vladimír Maisnar8. 1. Department of Internal Medicine, Hematology and Oncology, University Hospital, Brno, Czech Republic. 2. Department of Clinical Hematology, University Hospital, Ostrava, Czech Republic. 3. Babak Myeloma Group, Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic. 4. Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic. 5. Department of Internal Medicine, University Hospital, Praha, Czech Republic. 6. Department of Hemato-Oncology, University Hospital, Olomouc, Czech Republic. 7. Department of Clinical Hematology, University Hospital Kralovske Vinohrady, Praha, Czech Republic. 8. Department of Medicine - Hematology, University Hospital, Hradec Kralove, Czech Republic. 9. Department of Clinical Hematology, Hospital Liberec, Czech Republic. 10. Department of Hematology and Transfusion Medicine, Hospital Pelhřimov, Czech Republic. 11. Department of Hematology and Transfusion, Hospital Opava, Czech Republic. 12. Department of Clinical Hematology, Thomayer Hospital, Praha, Czech Republic. 13. Department of Clinical Hematology, Hospital České Budejovice, Czech Republic. 14. Department of Hematology and Transfusion, Hospital Mlada Boleslav, Czech Republic. 15. Department of Clinical Hematology, Hospital Havířov, Czech Republic. 16. Department of Clinical Hematology, Hospital Nový Jičín, Czech Republic. 17. Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic. 18. Laboratory of Molecular Cytogenetics, Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic. 19. Department of Clinical Hematology, University Hospital Brno, Brno, Czech Republic.
Abstract
INTRODUCTION: Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition with a risk of malignant conversion. PATIENTS AND METHODS: With the aim to estimate the cumulative risk MGUS progression to hematologic malignancies, we analyzed a nationwide population-based cohort of 1887 MGUS patients from the Czech Registry of Monoclonal Gammopathies (RMG) between 2007 and 2013. RESULTS: During the follow-up period (median 4 years; range 0.6-34.8), progression to hematologic malignancies was observed in 8.6% (162 of 1887) of patients. Factors associated with progression were as follows: M-protein concentration ≥1.5 g/dL, pathological sFLC (<0.26 or >1.65) ratio, bone marrow plasma cells (BMPCs) in cytology >5%, immunoparesis, age ≥69 years, and the level of serum hemoglobin at baseline <12.0 g/dL. Combining these factors, we propose a new risk model (CMG model). The risk of progression at 10 years was 1.6%, 16.9%, 22.9%, 39.4%, and 52.3%, respectively, if 0 (reference group), one, two, three, or four to five risk factors are present (P<.001) with HR 63 times higher compared to the reference MGUS group. CONCLUSION: The new CMG model was established with an advantage for better identification of MGUS patients at low risk.
INTRODUCTION:Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition with a risk of malignant conversion. PATIENTS AND METHODS: With the aim to estimate the cumulative risk MGUS progression to hematologic malignancies, we analyzed a nationwide population-based cohort of 1887 MGUS patients from the Czech Registry of Monoclonal Gammopathies (RMG) between 2007 and 2013. RESULTS: During the follow-up period (median 4 years; range 0.6-34.8), progression to hematologic malignancies was observed in 8.6% (162 of 1887) of patients. Factors associated with progression were as follows: M-protein concentration ≥1.5 g/dL, pathological sFLC (<0.26 or >1.65) ratio, bone marrow plasma cells (BMPCs) in cytology >5%, immunoparesis, age ≥69 years, and the level of serum hemoglobin at baseline <12.0 g/dL. Combining these factors, we propose a new risk model (CMG model). The risk of progression at 10 years was 1.6%, 16.9%, 22.9%, 39.4%, and 52.3%, respectively, if 0 (reference group), one, two, three, or four to five risk factors are present (P<.001) with HR 63 times higher compared to the reference MGUS group. CONCLUSION: The new CMG model was established with an advantage for better identification of MGUS patients at low risk.
Authors: Richard J Jones; Ram K Singh; Fazal Shirazi; Jie Wan; Hua Wang; Xiaobin Wang; Min Jin Ha; Muhamed Baljevic; Isere Kuiatse; Richard E Davis; Robert Z Orlowski Journal: Front Immunol Date: 2020-08-13 Impact factor: 7.561
Authors: Francisca Barceló; Rosa Gomila; Ivan de Paul; Xavier Gili; Jaume Segura; Albert Pérez-Montaña; Teresa Jimenez-Marco; Antonia Sampol; José Portugal Journal: PLoS One Date: 2018-08-02 Impact factor: 3.240