Publication details

Identification of patients with smouldering multiple myeloma at ultra-high risk of progression using serum parameters: the Czech Myeloma Group model

Authors	HÁJEK Roman SANDECKÁ Viera ŠPIČKA Ivan RAAB Marc GOLDSCHMIDT Hartmut BECK Susanne MINAŘÍK Jiří PAVLÍČEK Petr RADOCHA Jakub HEINDORFER Adriana JELÍNEK Tomáš STEJSKAL Lukáš BROŽOVÁ Lucie ŠEVČÍKOVÁ Sabina STRAUB Jan PIKA Tomáš POUR Luděk MAISNAR Vladimír SECKINGER Anja HOSE Dirk
Year of publication	2020
Type	Article in Periodical
Magazine / Source	British journal of haematology
MU Faculty or unit	Faculty of Medicine
Citation
web	https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.16572
Doi	http://dx.doi.org/10.1111/bjh.16572
Keywords	multiple myeloma; prognostic marker; risk factors; overall survival; progression-free survival
Description	Smouldering multiple myeloma (SMM) presents without MM defining symptoms. We aimed to identify patients with SMM with an 80% risk of progression within 2 years using only serum parameters. In total, 527 patients with SMM were included and divided into a training group (287 patients from the Czech Myeloma Group [CMG]) and an independent validation group (240 patients from Heidelberg). The median follow-up was 2 center dot 4 and 2 center dot 5 years, respectively. Progression to MM occurred in 51 center dot 9% of the CMG and 38 center dot 8% of the Heidelberg patients, respectively. The median risk of progression was 11 center dot 0% (CMG) and 9 center dot 7% (Heidelberg) per year, during the 5 years after diagnosis. A serum involved/uninvolved free light-chain ratio of >30, immunoparesis, and serum monoclonal (M) protein of >= 2 center dot 3 g/dl emerged as powerful predictors of 2-year progression rate with a hazard ratio (HR) of 2 center dot 49 (95% confidence interval [CI] 1 center dot 49-4 center dot 17), HR of 2 center dot 01 (95% CI 1 center dot 36-2 center dot 96) and HR of 2 center dot 00 (95% CI 1 center dot 44-2 center dot 79) (P < 0 center dot 001) in univariate Cox regression analysis, respectively. Based on this, the CMG model identified patients with SMM with a 2-year risk of progression of 78 center dot 7% (95% CI 53 center dot 1-95 center dot 7; HR 6 center dot 8;P < 0 center dot 001, CMG) and 81 center dot 3% (95% CI 47 center dot 1-98 center dot 8; HR 38 center dot 63;P < 0 center dot 001, Heidelberg). Serum parameters in the CMG model allow identification of patients with SMM with an 80% risk of progression to symptomatic MM within 2 years.