Identification of patients with smouldering multiple myeloma at ultra-high risk of progression using serum parameters: the Czech Myeloma Group model
Jazyk angličtina Země Anglie, Velká Británie Médium print-electronic
Typ dokumentu časopisecké články, práce podpořená grantem
Grantová podpora
IRP03_2018-2020
Ministerstvo Školství, Mládeže a Tělovýchovy - International
NV18-03-00203
Ministerstvo Zdravotnictví Ceské Republiky - International
RVO-FNOs/2015
Ministerstvo Zdravotnictví Ceské Republiky - International
RVO-FNOs/2017
Ministerstvo Zdravotnictví Ceské Republiky - International
Institutional Development Plan of University of Ostrava - International
PubMed
32163180
DOI
10.1111/bjh.16572
Knihovny.cz E-zdroje
- Klíčová slova
- multiple myeloma, overall survival, prognostic marker, progression-free survival, risk factors,
- MeSH
- dospělí MeSH
- doutnající mnohočetný myelom diagnóza patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- progrese nemoci MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Smouldering multiple myeloma (SMM) presents without MM defining symptoms. We aimed to identify patients with SMM with an 80% risk of progression within 2 years using only serum parameters. In total, 527 patients with SMM were included and divided into a training group (287 patients from the Czech Myeloma Group [CMG]) and an independent validation group (240 patients from Heidelberg). The median follow-up was 2·4 and 2·5 years, respectively. Progression to MM occurred in 51·9% of the CMG and 38·8% of the Heidelberg patients, respectively. The median risk of progression was 11·0% (CMG) and 9·7% (Heidelberg) per year, during the 5 years after diagnosis. A serum involved/uninvolved free light-chain ratio of >30, immunoparesis, and serum monoclonal (M) protein of ≥2·3 g/dl emerged as powerful predictors of 2-year progression rate with a hazard ratio (HR) of 2·49 (95% confidence interval [CI] 1·49-4·17), HR of 2·01 (95% CI 1·36-2·96) and HR of 2·00 (95% CI 1·44-2·79) (P < 0·001) in univariate Cox regression analysis, respectively. Based on this, the CMG model identified patients with SMM with a 2-year risk of progression of 78·7% (95% CI 53·1-95·7; HR 6·8; P < 0·001, CMG) and 81·3% (95% CI 47·1-98·8; HR 38·63; P < 0·001, Heidelberg). Serum parameters in the CMG model allow identification of patients with SMM with an 80% risk of progression to symptomatic MM within 2 years.
Department of Clinical Hematology Hospital Liberec Liberec Czech Republic
Department of Clinical Hematology University Hospital Brno Brno Czech Republic
Department of Clinical Hematology University Hospital Kralovske Vinohrady Praha Czech Republic
Department of Hemato Oncology University Hospital Olomouc Czech Republic
Department of Hemato Oncology University Hospital Ostrava Czech Republic
Department of Hematology and Transfusion Hospital Opava Opava Czech Republic
Department of Internal Medicine Hematology and Oncology University Hospital Brno Brno Czech Republic
Faculty of Medicine Institute of Biostatistics and Analyses Masaryk University Brno Czech Republic
Faculty of Medicine University of Ostrava Ostrava Czech Republic
Labor für Myelomforschung University Clinic Heidelberg Heidelberg Germany
Zobrazit více v PubMed
Bladé, J., Dimopoulos, M., Rosiñol, L., Rajkumar, S.V. & Kyle, R.A. (2010) Smoldering (asymptomatic) multiple myeloma: current diagnostic criteria, new predictors of outcome, and follow-up recommendations. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 28, 690-697.
Brozova, L., Schwarz, D., Snabl, I., Kalina, J., Pavlickova, B., Komenda, M., Jarkovský, J., Němec, P., Horinek, D., Stefanikova, Z., Pour, L. & Hájek, R. & Maisnar, V. (2017) Czech registry of monoclonal gammopathies - technical solution, data collection and visualisation. Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti, 30, 43-50.
Cesana, C., Klersy, C., Barbarano, L., Nosari, A.M., Crugnola, M., Pungolino, E., Gargantini, L., Granata, S., Valentini, M. & Morra, E. (2002) Prognostic factors for malignant transformation in monoclonal gammopathy of undetermined significance and smoldering multiple myeloma. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 20, 1625-1634.
Dispenzieri, A., Kyle, R.A., Katzmann, J.A., Therneau, T.M., Larson, D., Benson, J., Clark, R.J., Melton, L.J. 3rd, Gertz, M.A., Kumar, S.K., Fonseca, R., Jelinek, D.F. & Rajkumar, S.V. (2008) Immunoglobulin free light chain ratio is an independent risk factor for progression of smoldering (asymptomatic) multiple myeloma. Blood, 111, 785-789.
Hillengass, J., Fechtner, K., Weber, M.A., Bäuerle, T., Ayyaz, S., Heiss, C., Hielscher, T., Moehler, T.M., Egerer, G., Neben, K., Ho, A.D., Kauczor, H.U., Delorme, S. & Goldschmidt, H. (2010) Prognostic significance of focal lesions in whole-body magnetic resonance imaging in patients with asymptomatic multiple myeloma. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 28, 1606-1610.
International Myeloma Working Group. (2003) Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. British Journal of Haematology, 121, 749-757.
Kastritis, E., Moulopoulos, L.A., Terpos, E., Koutoulidis, V. & Dimopoulos, M.A. (2014) The prognostic importance of the presence of more than one focal lesion in spine MRI of patients with asymptomatic (smoldering) multiple myeloma. Leukemia, 28, 2402-2403.
Kyle, R.A., Remstein, E.D., Therneau, T.M., Dispenzieri, A., Kurtin, P.J., Hodnefield, J.M., Larson, D.R., Plevak, M.F., Jelinek, D.F., Fonseca, R., Melton, L.J. 3rd & Rajkumar, S.V. (2007) Clinical course and prognosis of smoldering (asymptomatic) multiple myeloma. New England Journal of Medicine, 356, 2582-2590.
Kyle, R.A., Durie, B.G.M., Rajkumar, S.V., Landgren, O., Blade, J., Merlini, G., Kröger, N., Einsele, H., Vesole, D.H., Dimopoulos, M., San Miguel, J., Avet-Loiseau, H., Hajek, R., Chen, W.M., Anderson, K.C., Ludwig, H., Sonneveld, P., Pavlovsky, S., Palumbo, A., Richardson, P.G., Barlogie, B., Greipp, P., Vescio, R., Turesson, I., Westin, J., & Boccadoro, M.; International Myeloma Working Group. (2010) Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management. Leukemia, 24, 1121-1127.
Lakshman, A., Rajkumar, S.V., Buadi, F.K., Binder, M., Gertz, M.A., Lacy, M.Q., Dispenzieri, A., Dingli, D., Fonder, A.L., Hayman, S.R., Hobbs, M.A., Gonsalves, W.I., Hwa, Y.L., Kapoor, P., Leung, N., Go, R.S., Lin, Y., Kourelis, T.V., Warsame, R., Lust, J.A., Russell, S.J., Zeldenrust, S.R., Kyle, R.A. & Kumar, S.K. (2018) Risk stratification of smoldering multiple myeloma incorporating revised IMWG diagnostic criteria. Blood Cancer Journal, 8, 59.
Landgren, O., Kyle, R.A. & Rajkumar, S.V. (2011) From myeloma precursor disease to multiple myeloma: new diagnostic concepts and opportunities for early intervention. Clinical Cancer Research: An Official Journal of the American Association for Cancer Research, 17, 1243-1252.
Larsen, J.T., Kumar, S.K., Dispenzieri, A., Kyle, R.A., Katzmann, J.A. & Rajkumar, S.V. (2013) Serum free light chain ratio as a biomarker for high-risk smoldering multiple myeloma. Leukemia, 27, 941-946.
Mateos, M.-V., Hernández, M.-T., Giraldo, P., de la Rubia, J., de Arriba, F., López Corral, L., Rosiñol, L., Paiva, B., Palomera, L., Bargay, J., Oriol, A., Prosper, F., López, J., Olavarría, E., Quintana, N., García, J.L., Bladé, J., Lahuerta, J.J. & San Miguel, J.F. (2013) Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. New England Journal of Medicine, 369, 438-447.
Merz, M., Hielscher, T., Wagner, B., Sauer, S., Shah, S., Raab, M.s, Jauch, A., Neben, K., Hose, D., Egerer, G., Weber, M.-A., Delorme, S., Goldschmidt, H. & Hillengass, J. (2014) Predictive value of longitudinal whole-body magnetic resonance imaging in patients with smoldering multiple myeloma. Leukemia, 28, 1902-1908.
Neben, K., Jauch, A., Hielscher, T., Hillengass, J., Lehners, N., Seckinger, A., Granzow, M., Raab, M.S., Ho, A.D., Goldschmidt, H. & Hose, D. (2013) Progression in smoldering myeloma is independently determined by the chromosomal abnormalities del(17p), t(4;14), gain 1q, hyperdiploidy, and tumor load. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 31, 4325-4332.
Pérez-Persona, E., Vidriales, M.B., Mateo, G., García-Sanz, R., Mateos, M.V., de Coca, A.G., Galende, J., Martín-Nuñez, G., Alonso, J.M., de Las, Heras N., Hernández, J.M., Martín, A., López-Berges, C., Orfao, A. & San Miguel, J.F. (2007) New criteria to identify risk of progression in monoclonal gammopathy of uncertain significance and smoldering multiple myeloma based on multiparameter flow cytometry analysis of bone marrow plasma cells. Blood, 110, 2586-2592.
Pérez-Persona, E., Mateo, G., García-Sanz, R., Mateos, M.V., de Las, Heras N., de Coca, A.G., Hernández, J.M., Galende, J., Martín-Nuñez, G., Bárez, A., Alonso, J.M., Martín, A., López-Berges, C., Orfao, A., San Miguel, J.F. & Vidriales, M.B. (2010) Risk of progression in smouldering myeloma and monoclonal gammopathies of unknown significance: comparative analysis of the evolution of monoclonal component and multiparameter flow cytometry of bone marrow plasma cells. British Journal of Haematology, 148, 110-114.
Rajkumar, S.V., Larson, D. & Kyle, R.A. (2011) Diagnosis of smoldering multiple myeloma. New England Journal of Medicine, 365, 474-475.
Rajkumar, S.V., Gupta, V., Fonseca, R., Dispenzieri, A., Gonsalves, W.I., Larson, D., Ketterling, R.P., Lust, J.A., Kyle, R.A. & Kumar, S.K. (2013) Impact of primary molecular cytogenetic abnormalities and risk of progression in smoldering multiple myeloma. Leukemia, 27, 1738-44.
Rajkumar, S.V., Dimopoulos, M.A., Palumbo, A., Blade, J., Merlini, G., Mateos, M.V., Kumar, S., Hillengass, J., Kastritis, E., Richardson, P., Landgren, O., Paiva, B., Dispenzieri, A., Weiss, B., LeLeu, X., Zweegman, S., Lonial, S., Rosinol, L., Zamagni, E., Jagannath, S., Sezer, O., Kristinsson, S.Y., Caers, J., Usmani, S.Z., Lahuerta, J.J., Johnsen, H.E., Beksac, M., Cavo, M., Goldschmidt, H., Terpos, E., Kyle, R.A., Anderson, K.C., Durie, B.G. & Miguel, J.F. (2014) International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. The Lancet. Oncology, 15, e538-548.
Rajkumar, S.V., Landgren, O. & Mateos, M.V. (2015) Smoldering multiple myeloma. Blood, 125, 3069-3075.
Sørrig, R., Klausen, T.W., Salomo, M., Vangsted, A.J., Østergaard, B., Gregersen, H., Frølund, U.C., Andersen, N.F., Helleberg, C., Andersen, K.T., Pedersen, R.S., Pedersen, P., Abildgaard, N. & Gimsing, P.; Danish Myeloma Study Group. (2016) Smoldering multiple myeloma risk factors for progression: a Danish population-based cohort study. European Journal of Haematology, 97, 303-309.
Waxman, A.J., Mick, R., Garfall, A.L., Cohen, A., Vogl, D.T., Stadtmauer, E.A. & Weiss, B.M. (2015) Classifying ultra-high risk smoldering myeloma. Leukemia, 29, 751-753.
Weber, D.M., Dimopoulos, M.A., Moulopoulos, L.A., Delasalle, K.B., Smith, T. & Alexanian, R. (1997) Prognostic features of asymptomatic multiple myeloma. British Journal of Haematology, 97, 810-814.
Zamagni, E., Nanni, C., Gay, F., Pezzi, A., Patriarca, F., Bellò, M., Rambaldi, I., Tacchetti, P., Hillengass, J., Gamberi, B., Pantani, L., Magarotto, V., Versari, A., Offidani, M., Zannetti, B., Carobolante, F., Balma, M., Musto, P., Rensi, M., Mancuso, K., Dimitrakopoulou-Strauss, A., Chauviè, S., Rocchi, S., Fard, N., Marzocchi, G., Storto, G., Ghedini, P., Palumbo, A., Fanti, S. & Cavo, M. (2016) 18F-FDG PET/CT focal, but not osteolytic, lesions predict the progression of smoldering myeloma to active disease. Leukemia, 30, 417-422.
