European journal of haematology · 2017
A first Czech analysis of 1887 cases with monoclonal gammopathy of undetermined significance.
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Sandecká Viera, Hájek Roman, Pour Luděk, Špička Ivan, Ščudla Vlastimil, Gregora Evžen, Radocha Jakub, Walterová Lenka, Kessler Petr, Zahradová Lenka, Adamová Dagmar, Valentova Kamila, Vonke Ivan, Obernauerová Jarmila, Starostka David, Wróbel Marek, Brožová Lucie, Jarkovský Jiří, Mikulášová Aneta, Říhová Lucie, Ševčíková Sabina, Straub Ján, Minařík Jiří, Adam Zdeněk, Krejčí Marta, Král Zdeněk, Maisnar Vladimír, Czech Myeloma Group
Аннотация
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.
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.
Предметные рубрики MeSH
AgedAged, 80 and overBiomarkersBone MarrowCell Transformation, NeoplasticCzech RepublicDisease ProgressionFemaleHumansIn Situ Hybridization, FluorescenceKaplan-Meier EstimateMaleMiddle AgedMonoclonal Gammopathy of Undetermined SignificanceMyeloma ProteinsPlasma CellsPopulation SurveillanceProportional Hazards ModelsRegistriesRisk AssessmentRisk Factors