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Monoclonal gammopathy of undetermined significance and the risk of thrombotic events : Results from iStopMM, a prospective population-based screening study

Rögnvaldsson, Sæmundur ; Gasparini, Alessandro ; Thorsteinsdottir, Sigrun ; Sverrisdottir, Ingigerdur ; Eythorsson, Elias ; Long, Thorir Einarsson LU ; Palmason, Robert LU ; Vidarsson, Brynjar ; Onundarson, Pall Torfi and Agnarsson, Bjarni A , et al. (2025) In British Journal of Haematology 206(3). p.899-906
Abstract

Monoclonal gammopathy of undetermined significance (MGUS) is the asymptomatic precursor of multiple myeloma and related diseases but has also been associated with thrombosis. Prior studies have not been based on screened cohorts leading to bias. We assessed the risk of thrombosis in a cohort of 75 422 individuals over 40 years old who were screened for MGUS in Iceland. We also evaluated the association of M protein concentration with thrombotic risk. A total of 3668 participants had MGUS. After a median follow-up of ~3.7 years, 124 venous and 252 arterial thrombotic events (10.3 and 21.0 per 1000 person years respectively) were observed in the MGUS group, compared to 1509 and 3471 in the non-MGUS group (6.0 and 13.8 per 1000 person... (More)

Monoclonal gammopathy of undetermined significance (MGUS) is the asymptomatic precursor of multiple myeloma and related diseases but has also been associated with thrombosis. Prior studies have not been based on screened cohorts leading to bias. We assessed the risk of thrombosis in a cohort of 75 422 individuals over 40 years old who were screened for MGUS in Iceland. We also evaluated the association of M protein concentration with thrombotic risk. A total of 3668 participants had MGUS. After a median follow-up of ~3.7 years, 124 venous and 252 arterial thrombotic events (10.3 and 21.0 per 1000 person years respectively) were observed in the MGUS group, compared to 1509 and 3471 in the non-MGUS group (6.0 and 13.8 per 1000 person years respectively). After adjusting for multiple confounders, MGUS was associated with an increased risk of venous thrombosis (hazard ratio [HR] = 1.43; 95% confidence interval [CI]: 1.19-1.73) but not arterial thrombosis (HR = 0.96; 95% CI: 0.87-1.13). M protein concentration was not associated with venous (p = 0.72) or arterial (p = 0.95) thrombosis. The findings show, in a screened cohort, that MGUS is associated with venous, but not arterial, thrombosis. Furthermore, they suggest that there is a subset of individuals with MGUS with subclinical monoclonal gammopathy of thrombotic significance.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
epidemiology, monoclonal gammopathy of undetermined significance, risk factors, thrombosis, venous thrombosis
in
British Journal of Haematology
volume
206
issue
3
pages
8 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:39721598
  • scopus:85212932470
ISSN
0007-1048
DOI
10.1111/bjh.19957
language
English
LU publication?
no
additional info
© 2024 British Society for Haematology and John Wiley & Sons Ltd.
id
4a5f2fc9-436b-47e0-8b92-1449fc253009
date added to LUP
2025-01-07 10:31:54
date last changed
2025-10-16 04:50:08
@article{4a5f2fc9-436b-47e0-8b92-1449fc253009,
  abstract     = {{<p>Monoclonal gammopathy of undetermined significance (MGUS) is the asymptomatic precursor of multiple myeloma and related diseases but has also been associated with thrombosis. Prior studies have not been based on screened cohorts leading to bias. We assessed the risk of thrombosis in a cohort of 75 422 individuals over 40 years old who were screened for MGUS in Iceland. We also evaluated the association of M protein concentration with thrombotic risk. A total of 3668 participants had MGUS. After a median follow-up of ~3.7 years, 124 venous and 252 arterial thrombotic events (10.3 and 21.0 per 1000 person years respectively) were observed in the MGUS group, compared to 1509 and 3471 in the non-MGUS group (6.0 and 13.8 per 1000 person years respectively). After adjusting for multiple confounders, MGUS was associated with an increased risk of venous thrombosis (hazard ratio [HR] = 1.43; 95% confidence interval [CI]: 1.19-1.73) but not arterial thrombosis (HR = 0.96; 95% CI: 0.87-1.13). M protein concentration was not associated with venous (p = 0.72) or arterial (p = 0.95) thrombosis. The findings show, in a screened cohort, that MGUS is associated with venous, but not arterial, thrombosis. Furthermore, they suggest that there is a subset of individuals with MGUS with subclinical monoclonal gammopathy of thrombotic significance.</p>}},
  author       = {{Rögnvaldsson, Sæmundur and Gasparini, Alessandro and Thorsteinsdottir, Sigrun and Sverrisdottir, Ingigerdur and Eythorsson, Elias and Long, Thorir Einarsson and Palmason, Robert and Vidarsson, Brynjar and Onundarson, Pall Torfi and Agnarsson, Bjarni A and Sigurdardottir, Margret and Olafsson, Isleifur and Thorsteinsdottir, Ingunn and Oskarsson, Jon Thorir and Jonsson, Asbjorn and Palsson, Runolfur and Indriðason, Olafur Skuli and Olafsson, Andri and Hultcrantz, Malin and Durie, Brian G M and Harding, Stephen and Landgren, Ola and Love, Thorvardur Jon and Kristinsson, Sigurdur Yngvi}},
  issn         = {{0007-1048}},
  keywords     = {{epidemiology; monoclonal gammopathy of undetermined significance; risk factors; thrombosis; venous thrombosis}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{899--906}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{British Journal of Haematology}},
  title        = {{Monoclonal gammopathy of undetermined significance and the risk of thrombotic events : Results from iStopMM, a prospective population-based screening study}},
  url          = {{http://dx.doi.org/10.1111/bjh.19957}},
  doi          = {{10.1111/bjh.19957}},
  volume       = {{206}},
  year         = {{2025}},
}