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Monoclonal gammopathy of undetermined significance and risk of lymphoid and myeloid malignancies: 728 cases followed up to 30 years in Sweden.

Turesson, Ingemar LU ; Kovalchik, Stephanie A; Pfeiffer, Ruth M; Kristinsson, Sigurdur Y; Goldin, Lynn R; Drayson, Mark T and Landgren, Ola (2014) In Blood 123(3). p.338-345
Abstract
In 728 Swedish cases of monoclonal gammopathy of undetermined significance (MGUS), followed up to 30 years (median 10 years), we estimated the cumulative risk of hematologic disorders originating from lymphoid and myeloid lineages. Using Cox regression models, we examined associations of demographic and laboratory factors with progression and determined the discriminatory power of three prediction models for progression. Eighty-four MGUS cases developed a lymphoid disorder, representing a cumulative risk of 15.4%. Multiple myeloma (MM) occurred in 53 patients and the 30-year cumulative risk was 10.6%; an approximate 0.5% annual risk. Three factors were significantly associated with progression: abnormal FLC-ratio (<0.26 or >1.65),... (More)
In 728 Swedish cases of monoclonal gammopathy of undetermined significance (MGUS), followed up to 30 years (median 10 years), we estimated the cumulative risk of hematologic disorders originating from lymphoid and myeloid lineages. Using Cox regression models, we examined associations of demographic and laboratory factors with progression and determined the discriminatory power of three prediction models for progression. Eighty-four MGUS cases developed a lymphoid disorder, representing a cumulative risk of 15.4%. Multiple myeloma (MM) occurred in 53 patients and the 30-year cumulative risk was 10.6%; an approximate 0.5% annual risk. Three factors were significantly associated with progression: abnormal FLC-ratio (<0.26 or >1.65), M-protein concentration ≥1.5g/dL ( > or = 1,5 g/dL), and reduction of 1 or 2 non-involved immunoglobulin isotype levels (immunoparesis). A prediction model with separate effects for these three factors and the M-protein isotype had higher discriminatory power than other models, though the differences were not statistically significant. The 30-year cumulative risk for myeloid malignancies was <2%. Our study confirms that abnormal FLC-ratio and M-protein concentration >1.5g/dL, factors previously considered by Mayo Clinic researchers, are predictors for MM progression and suggests that separate consideration of immunoparesis and the Mayo Clinic risk factors could improve identification of MGUS patients at high risk for progression. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Blood
volume
123
issue
3
pages
338 - 345
publisher
American Society of Hematology
external identifiers
  • wos:000329748700013
  • pmid:24222331
  • scopus:84893033900
ISSN
1528-0020
DOI
10.1182/blood-2013-05-505487
language
English
LU publication?
yes
id
20a5d7ef-365e-41b9-8762-01c8103275a5 (old id 4179489)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24222331?dopt=Abstract
date added to LUP
2013-12-03 20:35:01
date last changed
2017-09-24 03:10:12
@article{20a5d7ef-365e-41b9-8762-01c8103275a5,
  abstract     = {In 728 Swedish cases of monoclonal gammopathy of undetermined significance (MGUS), followed up to 30 years (median 10 years), we estimated the cumulative risk of hematologic disorders originating from lymphoid and myeloid lineages. Using Cox regression models, we examined associations of demographic and laboratory factors with progression and determined the discriminatory power of three prediction models for progression. Eighty-four MGUS cases developed a lymphoid disorder, representing a cumulative risk of 15.4%. Multiple myeloma (MM) occurred in 53 patients and the 30-year cumulative risk was 10.6%; an approximate 0.5% annual risk. Three factors were significantly associated with progression: abnormal FLC-ratio (&lt;0.26 or &gt;1.65), M-protein concentration ≥1.5g/dL ( &gt; or = 1,5 g/dL), and reduction of 1 or 2 non-involved immunoglobulin isotype levels (immunoparesis). A prediction model with separate effects for these three factors and the M-protein isotype had higher discriminatory power than other models, though the differences were not statistically significant. The 30-year cumulative risk for myeloid malignancies was &lt;2%. Our study confirms that abnormal FLC-ratio and M-protein concentration &gt;1.5g/dL, factors previously considered by Mayo Clinic researchers, are predictors for MM progression and suggests that separate consideration of immunoparesis and the Mayo Clinic risk factors could improve identification of MGUS patients at high risk for progression.},
  author       = {Turesson, Ingemar and Kovalchik, Stephanie A and Pfeiffer, Ruth M and Kristinsson, Sigurdur Y and Goldin, Lynn R and Drayson, Mark T and Landgren, Ola},
  issn         = {1528-0020},
  language     = {eng},
  number       = {3},
  pages        = {338--345},
  publisher    = {American Society of Hematology},
  series       = {Blood},
  title        = {Monoclonal gammopathy of undetermined significance and risk of lymphoid and myeloid malignancies: 728 cases followed up to 30 years in Sweden.},
  url          = {http://dx.doi.org/10.1182/blood-2013-05-505487},
  volume       = {123},
  year         = {2014},
}