Prognosis of young patients with monoclonal gammopathy of undetermined significance (MGUS).


Journal

Blood cancer journal
ISSN: 2044-5385
Titre abrégé: Blood Cancer J
Pays: United States
ID NLM: 101568469

Informations de publication

Date de publication:
01 02 2021
Historique:
received: 17 05 2020
accepted: 28 10 2020
entrez: 10 2 2021
pubmed: 11 2 2021
medline: 7 8 2021
Statut: epublish

Résumé

Monoclonal gammopathy of undetermined significance (MGUS) is rare in young patients (age <40 years at diagnosis), with a prevalence of <0.3%, representing ~2% of all patients with MGUS. We hypothesized that MGUS detected in young patients may be associated with a higher risk of progression. We examined 249 patients with MGUS < 40 years old. Among these, 135 patients had immune-related conditions, including infections, autoimmune and inflammatory disorders at the time of diagnosis of MGUS. The risk of progression to multiple myeloma or a related disorder at 5 years and 10 years was 6.0% and 13.8%, respectively. The size of M protein was a significant risk factor for progression (HR 4.2, 95% CI 2.2-7.9). There was a trend that the risk of progression was higher in patients without immune-related conditions (HR 2.36, 95% CI 0.85-6.52, p = 0.088). The M protein resolved in 36 (14%) patients, with a greater likelihood of resolution in patients with immune-related conditions (RR 1.9, 95% CI 1.02-3.6). Young patients with MGUS have a similar risk of progression as older patients, 1.4% per year. Over 50% are diagnosed in the setting of immune-related disorders. Patients with immune-related disorders may have a lower risk of progression.

Identifiants

pubmed: 33563898
doi: 10.1038/s41408-021-00406-6
pii: 10.1038/s41408-021-00406-6
pmc: PMC7873268
doi:

Substances chimiques

Myeloma Proteins 0
multiple myeloma M-proteins 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

26

Subventions

Organisme : NCI NIH HHS
ID : P50 CA186781
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA107476
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA168762
Pays : United States

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Auteurs

Li Pang (L)

Department of Medicine, NYC Health + Hospitals/Jacobi, Albert Einstein College of Medicine, Bronx, NY, USA.

S Vincent Rajkumar (SV)

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Prashant Kapoor (P)

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Francis Buadi (F)

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Angela Dispenzieri (A)

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Morie Gertz (M)

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Martha Lacy (M)

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Robert Kyle (R)

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Shaji Kumar (S)

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA. kumar.shaji@mayo.edu.

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Classifications MeSH