Evolving m-protein pattern in patients with smoldering multiple myeloma: impact on early progression

ABSTRACT Smoldering multiple myeloma (SMM) is a biologically heterogeneous, clinically defined entity with a variable rate of progression to symptomatic multiple myeloma (MM). Reliable

markers for progression are critical for the development of potential therapeutic interventions. We retrospectively evaluated the predictive value of the evolving pattern of serum M-protein

among other progression risk factors in 206 patients with SMM diagnosed between 1973 and 2012. Median time from recognition of evolving type to progression into symptomatic MM was 1.1 years

(95% CI 0.5–2.0) and progression rate at 3 years was 71%. Development of the evolving type drastically worsened the prognostic estimation made at diagnosis for every covariate predictive of

progression (serum M-protein size, bone marrow plasma cell infiltration, immunoparesis and Mayo Clinic risk). On average, the hazard ratio for progression to symptomatic MM increased to 5.1

(95% CI 3.4–7.6) after recognition of the evolving type. In conclusion, in patients with SMM the evolving pattern accurately predicts the risk of early progression to symptomatic disease,

thereby allowing the identification of ultra-high risk patients who would be candidates for immediate therapy. Access through your institution Buy or subscribe This is a preview of

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GROUP RISK STRATIFICATION MODEL FOR SMOLDERING MULTIPLE MYELOMA (SMM) Article Open access 16 October 2020 CLINICAL CHARACTERISTICS AND OUTCOMES IN RISK-STRATIFIED PATIENTS WITH SMOLDERING

MULTIPLE MYELOMA: DATA FROM THE CZECH REPUBLIC REGISTRY OF MONOCLONAL GAMMOPATHIES Article Open access 27 September 2023 ASSESSING THE PROGNOSTIC UTILITY OF SMOLDERING MULTIPLE MYELOMA RISK

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Scholar  Download references ACKNOWLEDGEMENTS We would like to thank Esther Bladé for her technical support in this research. This work has been supported in part by grants PI16/0423 and

PI12/1093 from Instituto de Salud Carlos III and Fondo Europeo de Desarrollo Regional (FEDER) “Una manera de hacer Europa” and 2014SGR-552 from Agència de Gestió d’Ajuts Universitaris i de

Recerca (Generalitat de Catalunya). AUTHOR CONTRIBUTIONS C.F.L. and I.I. designed the study, collected and analyzed data, performed statistical analysis, wrote and reviewed the paper; A.P.

analyzed data, performed statistical analysis, wrote and reviewed the paper; M.C., L.G.L.R., and N.T. collected data and reviewed the paper; X.C. and L.M. collected data, reviewed bone

marrow aspirates and reviewed the paper; M.R. reviewed bone marrow aspirates and reviewed the paper; J.I.A., E.L., T.D., and J.Y. collected data, performed laboratory assays and reviewed the

paper; L.R. and J.B. analyzed data and reviewed the paper. AUTHOR INFORMATION Author notes AUTHORS AND AFFILIATIONS * Department of Hematology, Amyloidosis and Myeloma Unit, Hospital

Clínic, IDIBAPS, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain Carlos Fernández de Larrea, Ignacio Isola, Ma Teresa Cibeira, Natalia Tovar, Luis-Gerardo Rodríguez-Lobato, 

Tania Díaz, Ester Lozano, Joan Bladé & Laura Rosiñol * Department of Hemotherapy and Hemostasis, Hospital Clínic, IDIBAPS, University of Barcelona, Villarroel 170, 08036, Barcelona,

Spain Arturo Pereira * Department of Hematopathology, Hospital Clínic, IDIBAPS, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain Laura Magnano, Xavier Calvo & María

Rozman * Department of Immunology, Amyloidosis and Myeloma Unit, Hospital Clínic, IDIBAPS, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain Juan I. Aróstegui & Jordi

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search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Joan Bladé. ETHICS DECLARATIONS CONFLICT OF INTEREST The authors declare that they have no conflict of

interest. ADDITIONAL INFORMATION Carlos Fernández de Larrea and Ignacio Isola contributed equally to this work ELECTRONIC SUPPLEMENTARY MATERIAL DEFINITION OF THE EVOLVING TYPE COMPARISON OF

MEDIAN TIME TO PROGRESSION IN PREVIOUSLY PUBLISHED HIGH RISK SMM MODELS RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Fernández de Larrea, C., Isola,

I., Pereira, A. _et al._ Evolving M-protein pattern in patients with smoldering multiple myeloma: impact on early progression. _Leukemia_ 32, 1427–1434 (2018).

https://doi.org/10.1038/s41375-018-0013-4 Download citation * Received: 26 September 2017 * Revised: 23 November 2017 * Accepted: 13 December 2017 * Published: 02 February 2018 * Issue Date:

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