A first Czech analysis of 1887 cases with monoclonal gammopathy of undetermined significance. (11th May 2017)

• Record Type: Journal Article
• Authors: 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
• Is Part Of: European journal of haematology. Volume 99:Number 1(2017)
• Page Start: 80
• Page End: 90
• Publication Date: 2017-05-11
• Subjects: monoclonal gammopathy -- multiple myeloma -- progression -- risk factors; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.12894
• Languages: English
• ISSNs: 0902-4441

Abstract

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.