TY - JOUR
TI - International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM)
AU - Mateos, M.-V.
AU - Kumar, S.
AU - Dimopoulos, M.A.
AU - González-Calle, V.
AU - Kastritis, E.
AU - Hajek, R.
AU - De Larrea, C.F.
AU - Morgan, G.J.
AU - Merlini, G.
AU - Goldschmidt, H.
AU - Geraldes, C.
AU - Gozzetti, A.
AU - Kyriakou, C.
AU - Garderet, L.
AU - Hansson, M.
AU - Zamagni, E.
AU - Fantl, D.
AU - Leleu, X.
AU - Kim, B.-S.
AU - Esteves, G.
AU - Ludwig, H.
AU - Usmani, S.
AU - Min, C.-K.
AU - Qi, M.
AU - Ukropec, J.
AU - Weiss, B.M.
AU - Rajkumar, S.V.
AU - Durie, B.G.M.
AU - San-Miguel, J.
JO - Blood cancer journal
PY - 2020
VL - 10
TODO - 10
SP - null
PB - Springer Nature BV
SN - null
TODO - 10.1038/s41408-020-00366-3
TODO - beta 2 microglobulin;  biological marker;  creatinine;  hemoglobin;  immunoglobulin A;  immunoglobulin D;  immunoglobulin G;  immunoglobulin M;  M protein;  immunoglobulin light chain;  multiple myeloma M-proteins;  paraprotein;  tumor marker, adult;  aged;  albumin blood level;  amyloidosis;  analysis;  Article;  cancer growth;  cell infiltration;  clinical practice;  clinical research;  cohort analysis;  creatinine blood level;  cytogenetics;  female;  fluorescence in situ hybridization;  follow up;  hemoglobin blood level;  human;  light chain;  major clinical study;  male;  medical record review;  plasma cell;  protein blood level;  random forest;  retrospective study;  risk factor;  smoldering multiple myeloma;  trisomy 13;  biological model;  blood;  clinical trial;  disease exacerbation;  metabolism;  middle aged;  multicenter study;  multiple myeloma, Aged;  Biomarkers, Tumor;  Disease Progression;  Female;  Follow-Up Studies;  Humans;  Immunoglobulin Light Chains;  Male;  Middle Aged;  Models, Biological;  Multiple Myeloma;  Myeloma Proteins;  Risk Factors
TODO - Smoldering multiple myeloma (SMM) is an asymptomatic precursor state of multiple myeloma (MM). Recently, MM was redefined to include biomarkers predicting a high risk of progression from SMM, thus necessitating a redefinition of SMM and its risk stratification. We assembled a large cohort of SMM patients meeting the revised IMWG criteria to develop a new risk stratification system. We included 1996 patients, and using stepwise selection and multivariable analysis, we identified three independent factors predicting progression risk at 2 years: serum M-protein >2 g/dL (HR: 2.1), involved to uninvolved free light-chain ratio >20 (HR: 2.7), and marrow plasma cell infiltration >20% (HR: 2.4). This translates into 3 categories with increasing 2-year progression risk: 6% for low risk (38%; no risk factors, HR: 1); 18% for intermediate risk (33%; 1 factor; HR: 3.0), and 44% for high risk (29%; 2–3 factors). Addition of cytogenetic abnormalities (t(4;14), t(14;16), +1q, and/or del13q) allowed separation into 4 groups (low risk with 0, low intermediate risk with 1, intermediate risk with 2, and high risk with ≥3 risk factors) with 6, 23, 46, and 63% risk of progression in 2 years, respectively. The 2/20/20 risk stratification model can be easily implemented to identify high-risk SMM for clinical research and routine practice and will be widely applicable. © 2020, The Author(s).
ER -