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International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM)
Smoldering multiple myeloma (SMM) is an asymptomatic precursor state of multiple myeloma (MM). Recently, MM was redefined to include biomarkers predicting a high risk of progression from SMM, thus necessitating a redefinition of SMM and its risk stratification. We assembled a large cohort of SMM pat...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567803/ https://www.ncbi.nlm.nih.gov/pubmed/33067414 http://dx.doi.org/10.1038/s41408-020-00366-3 |
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author | Mateos, María-Victoria Kumar, Shaji Dimopoulos, Meletios A. González-Calle, Verónica Kastritis, Efstathios Hajek, Roman De Larrea, Carlos Fernández Morgan, Gareth J. Merlini, Giampaolo Goldschmidt, Hartmut Geraldes, Catarina Gozzetti, Alessandro Kyriakou, Charalampia Garderet, Laurent Hansson, Markus Zamagni, Elena Fantl, Dorotea Leleu, Xavier Kim, Byung-Su Esteves, Graça Ludwig, Heinz Usmani, Saad Min, Chang-Ki Qi, Ming Ukropec, Jon Weiss, Brendan M. Rajkumar, S. Vincent Durie, Brian G. M. San-Miguel, Jesús |
author_facet | Mateos, María-Victoria Kumar, Shaji Dimopoulos, Meletios A. González-Calle, Verónica Kastritis, Efstathios Hajek, Roman De Larrea, Carlos Fernández Morgan, Gareth J. Merlini, Giampaolo Goldschmidt, Hartmut Geraldes, Catarina Gozzetti, Alessandro Kyriakou, Charalampia Garderet, Laurent Hansson, Markus Zamagni, Elena Fantl, Dorotea Leleu, Xavier Kim, Byung-Su Esteves, Graça Ludwig, Heinz Usmani, Saad Min, Chang-Ki Qi, Ming Ukropec, Jon Weiss, Brendan M. Rajkumar, S. Vincent Durie, Brian G. M. San-Miguel, Jesús |
author_sort | Mateos, María-Victoria |
collection | PubMed |
description | Smoldering multiple myeloma (SMM) is an asymptomatic precursor state of multiple myeloma (MM). Recently, MM was redefined to include biomarkers predicting a high risk of progression from SMM, thus necessitating a redefinition of SMM and its risk stratification. We assembled a large cohort of SMM patients meeting the revised IMWG criteria to develop a new risk stratification system. We included 1996 patients, and using stepwise selection and multivariable analysis, we identified three independent factors predicting progression risk at 2 years: serum M-protein >2 g/dL (HR: 2.1), involved to uninvolved free light-chain ratio >20 (HR: 2.7), and marrow plasma cell infiltration >20% (HR: 2.4). This translates into 3 categories with increasing 2-year progression risk: 6% for low risk (38%; no risk factors, HR: 1); 18% for intermediate risk (33%; 1 factor; HR: 3.0), and 44% for high risk (29%; 2–3 factors). Addition of cytogenetic abnormalities (t(4;14), t(14;16), +1q, and/or del13q) allowed separation into 4 groups (low risk with 0, low intermediate risk with 1, intermediate risk with 2, and high risk with ≥3 risk factors) with 6, 23, 46, and 63% risk of progression in 2 years, respectively. The 2/20/20 risk stratification model can be easily implemented to identify high-risk SMM for clinical research and routine practice and will be widely applicable. |
format | Online Article Text |
id | pubmed-7567803 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-75678032020-10-19 International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM) Mateos, María-Victoria Kumar, Shaji Dimopoulos, Meletios A. González-Calle, Verónica Kastritis, Efstathios Hajek, Roman De Larrea, Carlos Fernández Morgan, Gareth J. Merlini, Giampaolo Goldschmidt, Hartmut Geraldes, Catarina Gozzetti, Alessandro Kyriakou, Charalampia Garderet, Laurent Hansson, Markus Zamagni, Elena Fantl, Dorotea Leleu, Xavier Kim, Byung-Su Esteves, Graça Ludwig, Heinz Usmani, Saad Min, Chang-Ki Qi, Ming Ukropec, Jon Weiss, Brendan M. Rajkumar, S. Vincent Durie, Brian G. M. San-Miguel, Jesús Blood Cancer J Article Smoldering multiple myeloma (SMM) is an asymptomatic precursor state of multiple myeloma (MM). Recently, MM was redefined to include biomarkers predicting a high risk of progression from SMM, thus necessitating a redefinition of SMM and its risk stratification. We assembled a large cohort of SMM patients meeting the revised IMWG criteria to develop a new risk stratification system. We included 1996 patients, and using stepwise selection and multivariable analysis, we identified three independent factors predicting progression risk at 2 years: serum M-protein >2 g/dL (HR: 2.1), involved to uninvolved free light-chain ratio >20 (HR: 2.7), and marrow plasma cell infiltration >20% (HR: 2.4). This translates into 3 categories with increasing 2-year progression risk: 6% for low risk (38%; no risk factors, HR: 1); 18% for intermediate risk (33%; 1 factor; HR: 3.0), and 44% for high risk (29%; 2–3 factors). Addition of cytogenetic abnormalities (t(4;14), t(14;16), +1q, and/or del13q) allowed separation into 4 groups (low risk with 0, low intermediate risk with 1, intermediate risk with 2, and high risk with ≥3 risk factors) with 6, 23, 46, and 63% risk of progression in 2 years, respectively. The 2/20/20 risk stratification model can be easily implemented to identify high-risk SMM for clinical research and routine practice and will be widely applicable. Nature Publishing Group UK 2020-10-16 /pmc/articles/PMC7567803/ /pubmed/33067414 http://dx.doi.org/10.1038/s41408-020-00366-3 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Mateos, María-Victoria Kumar, Shaji Dimopoulos, Meletios A. González-Calle, Verónica Kastritis, Efstathios Hajek, Roman De Larrea, Carlos Fernández Morgan, Gareth J. Merlini, Giampaolo Goldschmidt, Hartmut Geraldes, Catarina Gozzetti, Alessandro Kyriakou, Charalampia Garderet, Laurent Hansson, Markus Zamagni, Elena Fantl, Dorotea Leleu, Xavier Kim, Byung-Su Esteves, Graça Ludwig, Heinz Usmani, Saad Min, Chang-Ki Qi, Ming Ukropec, Jon Weiss, Brendan M. Rajkumar, S. Vincent Durie, Brian G. M. San-Miguel, Jesús International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM) |
title | International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM) |
title_full | International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM) |
title_fullStr | International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM) |
title_full_unstemmed | International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM) |
title_short | International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM) |
title_sort | international myeloma working group risk stratification model for smoldering multiple myeloma (smm) |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567803/ https://www.ncbi.nlm.nih.gov/pubmed/33067414 http://dx.doi.org/10.1038/s41408-020-00366-3 |
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