Baseline serum B-cell maturation antigen levels predict time to disease progression for patients with smoldering multiple myeloma.
Adult
Aged
Aged, 80 and over
B-Cell Maturation Antigen
/ blood
Biomarkers, Tumor
/ blood
Disease Progression
Female
Glycoproteins
/ blood
Humans
Immunoglobulin kappa-Chains
/ blood
Immunoglobulin lambda-Chains
/ blood
Male
Middle Aged
Plasma Cells
/ immunology
Prognosis
Proportional Hazards Models
ROC Curve
Risk Factors
Smoldering Multiple Myeloma
/ blood
Smoldering Multiple Myeloma (SMM)
biomarker
disease progression
serum B-cell maturation antigen (sBCMA)
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
revised:
10
05
2021
received:
29
03
2021
accepted:
12
05
2021
pubmed:
17
5
2021
medline:
20
1
2022
entrez:
16
5
2021
Statut:
ppublish
Résumé
Multiple myeloma (MM) patients with smoldering (S) disease are defined by a lack of CRAB/SLiM criteria but may transform into disease requiring treatment. The International Myeloma Working Group risk stratification model for SMM uses serum M-protein, serum-free light chain ratio, and bone marrow plasma cell percentage. We investigated whether baseline serum B-cell maturation antigen (sBCMA) levels are predictive of disease progression among 65 patients with SMM. A receiver operating characteristic curve was used to establish a definition for high-risk baseline sBCMA. Mantel Byar analysis was used to examine whether high-risk sBCMA was correlated with shorter time to transformation, and a time-dependent cox proportional hazard was used to determine whether it is independent of other risk factors. A z test for proportions was used to compare the percentage of patients that progressed among high-risk versus low-risk sBCMA patients. A baseline sBCMA level ≥137.5 mg/ml was found to be the optimal cutoff between high- and low-risk SMM patients. Patients with high-risk sBCMA levels had a shorter time to transformation (P = .000332). sBCMA was also higher at the time of transformation than baseline levels (P = .0116). sBCMA was the only variable found to be significantly predictive of time to transformation and additionally was found to be independent of other risk factors. In this study, we have shown for the first time that sBCMA levels predict transformation of SMM to active disease and that these levels increase at the time of transformation. These results are consistent with other studies showing that active MM patients undergoing therapy with higher baseline sBCMA levels are more likely to progress early and its levels increase at the time of disease progression.
Substances chimiques
B-Cell Maturation Antigen
0
Biomarkers, Tumor
0
Glycoproteins
0
Immunoglobulin kappa-Chains
0
Immunoglobulin lambda-Chains
0
TNFRSF17 protein, human
0
protein M (glycoprotein)
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
318-323Informations de copyright
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International myeloma working group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):e538-e548.
Wu V, Moshier E, Leng S, et al. Risk stratification of smoldering multiple myeloma: predictive value of free light chains and group-based trajectory modeling. Blood Adv. 2018;2(12):1470-1479.
Lonial S, Jacobus S, Weiss M, et al. E3A06: Randomized phase III trial of lenalidomide versus observation alone in patients with asymptomatic high-risk smoldering multiple myeloma. J Clini Oncol. 2019;37(Suppl. 15):8001.
Landgren CO, Chari A, Cohen YC, et al. Daratumumab monotherapy for patients with intermediate-risk or high-risk smoldering multiple myeloma: a randomized, open-label, multicenter, phase 2 study (CENTAURUS). Leukemia. 2020;34(7):1840-1852.
Mateos MV, Kumar S, Dimopoulos MA, et al. International myeloma working group risk stratification model for smoldering multiple myeloma (SMM). Blood Cancer J. 2020;10(10):102.
Bustoros M, Sklavenitis-Pistofidis R, Park J, et al. Genomic profiling of smoldering multiple myeloma identifies patients at a high risk of disease progression. J Clin Oncol. 2020;38(21):2380-2389.
Hájek R, Sandecka V, Špička I, et al. Identification of patients with smouldering multiple myeloma at ultra-high risk of progression using serum parameters: the czech myeloma group model. Br J Haematol. 2020;190(2):189-197.
Bianchi G, Kyle RA, Larson DR, et al. High levels of peripheral blood circulating plasma cells as a specific risk factor for progression of smoldering multiple myeloma. Leukemia. 2013;27(3):680-685.
Rajkumar SV, Gupta V, Fonseca R, et al. Impact of primary molecular cytogenetic abnormalities and risk of progression in smoldering multiple myeloma. Leukemia. 2013;27(8):1738-1744.
Ghermezi M, Li M, Vardanyan S, et al. Serum B-cell maturation antigen: a novel biomarker to predict outcomes for multiple myeloma patients. Haematologica. 2017;102(4):785-795.
Bujarski S, Soof C, Chen H, et al. Serum B-cell maturation antigen levels predict progression free survival and responses among relapsed or refractory multiple myeloma patients treated on the phase I IRUX trial. J Clin Oncol. 2018;36:(abstract e24313).
Dispenzieri A, Soof CM, Rajkumar V, et al. Serum BCMA levels predict outcomes for patients with MGUS and smoldering multiple myeloma (SMM). J Clin Oncol 37, 2019;(suppl: abstr 8020). e486.
Ravindran A, Bartley AC, Holton SJ, et al. Prevalence, incidence and survival of smoldering multiple myeloma in the United States. Blood Cancer J. 2016;6(10):e486.
Joseph NS, Dhodapkar MV, Lonial S. The role of early intervention in high-risk smoldering myeloma. Am Soc Clin Oncol Educ Book. 2020;40:1-9.