Monoclonal gammopathy of undetermined significance with multiple paraproteins : A population-based screening study
(2024) In HemaSphere 8(11). p.1-7- Abstract
Monoclonal gammopathy of undetermined significance (MGUS) is the precursor of multiple myeloma (MM) and related disorders. MGUS is characterized by asymptomatic paraproteinemia. In some cases, multiple paraproteins can be identified but the clinical implications of this phenomenon are poorly understood. In this study, we aim to inform the approach to this challenging MGUS subgroup by utilizing data from iStopMM, a population-based screening study and randomized trial of follow-up strategies. In total, 75,422 Icelanders over the age of 40 were screened for MGUS with 3389 (4.4%) having at least one paraprotein of whom 303 (9%) had multiple paraproteins. IgM paraproteins were more common in those with multiple paraproteins (49% vs. 27% of... (More)
Monoclonal gammopathy of undetermined significance (MGUS) is the precursor of multiple myeloma (MM) and related disorders. MGUS is characterized by asymptomatic paraproteinemia. In some cases, multiple paraproteins can be identified but the clinical implications of this phenomenon are poorly understood. In this study, we aim to inform the approach to this challenging MGUS subgroup by utilizing data from iStopMM, a population-based screening study and randomized trial of follow-up strategies. In total, 75,422 Icelanders over the age of 40 were screened for MGUS with 3389 (4.4%) having at least one paraprotein of whom 303 (9%) had multiple paraproteins. IgM paraproteins were more common in those with multiple paraproteins (49% vs. 27% of paraproteins, p < 0.001), and IgM and non-IgM paraproteins frequently co-occurred (60% of cases). Two-thirds of these participants were randomized to active follow-up where only 31% of multiple paraproteins were persistent. Paraprotein concentrations were mostly independent, and although progression events were few, the progression rate was similar between those with multiple paraproteins and a single paraprotein. In a next-generation flow cytometry (NGF) sub-study, two phenotypically distinct aberrant plasma cell populations could be identified in some with multiple paraproteins. The findings suggest that multiple paraproteins often reflect independent ongoing disease processes that should be monitored independently but otherwise treated similarly to other MGUS cases. Specifically, the findings highlight the need for independent monitoring of IgM and non-IgM paraproteins in these individuals. The study provides novel insights into the management of this understudied MGUS subset.
(Less)
- author
- publishing date
- 2024-11
- type
- Contribution to journal
- publication status
- published
- in
- HemaSphere
- volume
- 8
- issue
- 11
- article number
- e70046
- pages
- 1 - 7
- publisher
- Wolters Kluwer
- external identifiers
-
- pmid:39564537
- scopus:85209636213
- ISSN
- 2572-9241
- DOI
- 10.1002/hem3.70046
- language
- English
- LU publication?
- no
- additional info
- © 2024 The Author(s). HemaSphere published by John Wiley & Sons Ltd on behalf of European Hematology Association.
- id
- f4dda1a2-c1da-4b7e-af6b-26aae65c6e0f
- date added to LUP
- 2024-12-05 16:05:00
- date last changed
- 2025-01-17 07:31:36
@article{f4dda1a2-c1da-4b7e-af6b-26aae65c6e0f,
abstract = {{<p>Monoclonal gammopathy of undetermined significance (MGUS) is the precursor of multiple myeloma (MM) and related disorders. MGUS is characterized by asymptomatic paraproteinemia. In some cases, multiple paraproteins can be identified but the clinical implications of this phenomenon are poorly understood. In this study, we aim to inform the approach to this challenging MGUS subgroup by utilizing data from iStopMM, a population-based screening study and randomized trial of follow-up strategies. In total, 75,422 Icelanders over the age of 40 were screened for MGUS with 3389 (4.4%) having at least one paraprotein of whom 303 (9%) had multiple paraproteins. IgM paraproteins were more common in those with multiple paraproteins (49% vs. 27% of paraproteins, p < 0.001), and IgM and non-IgM paraproteins frequently co-occurred (60% of cases). Two-thirds of these participants were randomized to active follow-up where only 31% of multiple paraproteins were persistent. Paraprotein concentrations were mostly independent, and although progression events were few, the progression rate was similar between those with multiple paraproteins and a single paraprotein. In a next-generation flow cytometry (NGF) sub-study, two phenotypically distinct aberrant plasma cell populations could be identified in some with multiple paraproteins. The findings suggest that multiple paraproteins often reflect independent ongoing disease processes that should be monitored independently but otherwise treated similarly to other MGUS cases. Specifically, the findings highlight the need for independent monitoring of IgM and non-IgM paraproteins in these individuals. The study provides novel insights into the management of this understudied MGUS subset.</p>}},
author = {{Rögnvaldsson, Sæmundur and Óskarsson, Jón Þ and Thorsteinsdóttir, Sigrun and Hultcrantz, Malin and Palmason, Robert and Sverrisdottir, Ingigerdur S and Eythorsson, Elias and Long, Thorir E and Olafsson, Isleifur and Thorsteinsdottir, Ingunn and Vidarsson, Brynjar and Onundarson, Pall T and Agnarsson, Bjarni A and Sigurdardottir, Margret and Jonsson, Asbjorn and Durie, Brian G M and Harding, Stephen and Landgren, Ola and Love, Thorvardur J and Kristinsson, Sigurdur Y}},
issn = {{2572-9241}},
language = {{eng}},
number = {{11}},
pages = {{1--7}},
publisher = {{Wolters Kluwer}},
series = {{HemaSphere}},
title = {{Monoclonal gammopathy of undetermined significance with multiple paraproteins : A population-based screening study}},
url = {{http://dx.doi.org/10.1002/hem3.70046}},
doi = {{10.1002/hem3.70046}},
volume = {{8}},
year = {{2024}},
}