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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
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.
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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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