Τίτλος:
International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM)
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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).
Συγγραφείς:
Mateos, M.-V.
Kumar, S.
Dimopoulos, M.A.
González-Calle, V.
Kastritis, E.
Hajek, R.
De Larrea, C.F.
Morgan, G.J.
Merlini, G.
Goldschmidt, H.
Geraldes, C.
Gozzetti, A.
Kyriakou, C.
Garderet, L.
Hansson, M.
Zamagni, E.
Fantl, D.
Leleu, X.
Kim, B.-S.
Esteves, G.
Ludwig, H.
Usmani, S.
Min, C.-K.
Qi, M.
Ukropec, J.
Weiss, B.M.
Rajkumar, S.V.
Durie, B.G.M.
San-Miguel, J.
Περιοδικό:
Blood cancer journal
Εκδότης:
Springer Nature BV
Λέξεις-κλειδιά:
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
DOI:
10.1038/s41408-020-00366-3
