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

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 My...

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Main Authors: Hájek, Roman (Author) , Sandecka, Viera (Author) , Špička, Ivan (Author) , Raab, Marc-Steffen (Author) , Goldschmidt, Hartmut (Author) , Beck, Susanne (Author) , Minařík, Jiří (Author) , Pavlíček, Petr (Author) , Radocha, Jakub (Author) , Heindorfer, Adriana (Author) , Jelínek, Tomáš (Author) , Stejskal, Lukáš (Author) , Brožová, Lucie (Author) , Ševčíková, Sabina (Author) , Straub, Jan (Author) , Pika, Tomáš (Author) , Pour, Luděk (Author) , Maisnar, Vladimír (Author) , Seckinger, Anja (Author) , Hose, Dirk (Author)
Format: Article (Journal)
Language:English
Published: 12 March 2020
In: British journal of haematology
Year: 2020, Volume: 190, Issue: 2, Pages: 189-197
ISSN:1365-2141
DOI:10.1111/bjh.16572
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1111/bjh.16572
Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/bjh.16572
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Author Notes:Roman Hájek, Viera Sandecka, Ivan Špička, Marc Raab, Hartmut Goldschmidt, Susanne Beck, Jiří Minařík, Petr Pavlíček, Jakub Radocha, Adriana Heindorfer, Tomáš Jelínek, Lukáš Stejskal, Lucie Brožová, Sabina Ševčíková, Jan Straub, Tomáš Pika, Luděk Pour, Vladimír Maisnar, Anja Seckinger and Dirk Hose

MARC

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520 |a 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 2·4 and 2·5 years, respectively. Progression to MM occurred in 51·9% of the CMG and 38·8% of the Heidelberg patients, respectively. The median risk of progression was 11·0% (CMG) and 9·7% (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 ≥2·3 g/dl emerged as powerful predictors of 2-year progression rate with a hazard ratio (HR) of 2·49 (95% confidence interval [CI] 1·49-4·17), HR of 2·01 (95% CI 1·36-2·96) and HR of 2·00 (95% CI 1·44-2·79) (P < 0·001) in univariate Cox regression analysis, respectively. Based on this, the CMG model identified patients with SMM with a 2-year risk of progression of 78·7% (95% CI 53·1-95·7; HR 6·8; P < 0·001, CMG) and 81·3% (95% CI 47·1-98·8; HR 38·63; P < 0·001, 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. 
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