MGUS Can Progress to Multiple Myeloma Within Five Years

Individuals with low- or intermediate-risk monoclonal gammopathy of undetermined significance (MGUS) can experience progression to multiple myeloma within five years, according to a study published online in JAMA Oncology.

Ola Landgren, M.D., Ph.D., from Memorial Sloan Kettering Cancer Center in New York City, and colleagues conducted a cross-sectional cohort study involving 77,469 adults aged 55 to 74 years who had a diagnosis of progressing MGUS (187 patients) or stable MGUS (498 patients) from November 1993 through December 2011. All available serially stored prediagnostic serum samples were obtained for each participant (3,266 samples).

Through cross-sectional modeling, the researchers found that risk factors associated with progressive MGUS were immunoglobulin A isotype, a monoclonal spike of 15 g/L or more, a skewed (<0.1 or >10) serum free light chains ratio, and severe immunoparesis (at least two suppressed uninvolved immunoglobulins; adjusted odds ratios, 1.80, 23.5, 46.4, and 19.1, respectively). Skewed serum free light chains ratio and severe immunoparesis were associated with progressive light-chain MGUS (adjusted odds ratios, 44.0 and 48.6, respectively). In participants with serial samples prior to progression, 53 percent of 43 participants had high-risk MGUS before progression; 70 percent of these patients experienced conversion from low- or intermediate-risk MGUS to multiple myeloma within five years. The results were similar for light-chain MGUS.

"Our results may be clinically relevant and support annual blood tests for all individuals diagnosed with MGUS or light-chain MGUS," the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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