Journal article
Risk stratification of smoldering multiple myeloma incorporating revised IMWG diagnostic criteria
Blood cancer journal (New York), v 8(6), pp 59-10
12 Jun 2018
PMID: 29895887
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
In 2014, the International Myeloma Working Group reclassified patients with smoldering multiple myeloma (SMM) and bone marrow-plasma cell percentage (BMPC%) >= 60%, or serum free light chain ratio (FLCr) >= 100 or > 1 focal lesion on magnetic resonance imaging as multiple myeloma (MM). Predictors of progression in patients currently classified as SMM are not known. We identified 421 patients with SMM, diagnosed between 2003 and 2015. The median time to progression (TTP) was 57 months (CI, 45-72). BMPC% > 20% [hazard ratio (HR): 2.28 (CI, 1.63-3.20); p < 0.0001]; Mprotein > 2g/dL [HR: 1.56 (CI, 1.11-2.20); p = 0.01], and FLCr > 20 [HR: 2.13 (CI, 1.55-2.93); p < 0.0001] independently predicted shorter TTP in multivariate analysis. Age and immunoparesis were not significant. We stratified patients into three groups: low risk (none of the three risk factors; n = 143); intermediate risk (one of the three risk factors; n = 121); and high risk (>= 2 of the three risk factors; n = 153). The median TTP for low-, intermediate-, and high-risk groups were 110, 68, and 29 months, respectively (p < 0.0001). BMPC% > 20%, M-protein > 2 g/dL, and FLCr > 20 at diagnosis can be used to risk stratify patients with SMM. Patients with high-risk SMM need close follow-up and are candidates for clinical trials aiming to prevent progression.
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Details
- Title
- Risk stratification of smoldering multiple myeloma incorporating revised IMWG diagnostic criteria
- Creators
- Arjun Lakshman - Mayo Clinic in ArizonaS. Vincent Rajkumar - Mayo Clinic in ArizonaFrancis K. Buadi - Mayo Clinic in ArizonaMoritz Binder - Mayo Clinic in ArizonaMorie A. Gertz - Mayo Clinic in ArizonaMartha Q. Lacy - Mayo Clinic in ArizonaAngela Dispenzieri - Mayo Clinic in ArizonaDavid Dingli - Mayo Clinic in ArizonaAmie L. Fonder - Mayo Clinic in ArizonaSuzanne R. Hayman - Mayo Clinic in ArizonaMiriam A. Hobbs - Mayo Clinic in ArizonaWilson I. Gonsalves - Mayo Clinic in ArizonaYi Lisa Hwa - Mayo Clinic in ArizonaPrashant Kapoor - Mayo Clinic in ArizonaNelson Leung - Mayo Clinic in ArizonaRonald S. Go - Mayo Clinic in ArizonaYi Lin - Mayo Clinic in ArizonaTaxiarchis V. Kourelis - Mayo Clinic in ArizonaRahma Warsame - Mayo Clinic in ArizonaJohn A. Lust - Mayo Clinic in ArizonaStephen J. Russell - Mayo Clinic in ArizonaSteven R. Zeldenrust - Mayo Clinic in ArizonaRobert A. Kyle - Mayo Clinic in ArizonaShaji K. Kumar - Mayo Clinic in Arizona
- Publication Details
- Blood cancer journal (New York), v 8(6), pp 59-10
- Publisher
- Springer Nature
- Number of pages
- 10
- Grant note
- CA168762; CA107476 / National Cancer Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000435151800002
- Scopus ID
- 2-s2.0-85048364108
- Other Identifier
- 991022059919704721
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Highly Cited Paper
- Web of Science research areas
- Hematology
- Oncology