1. A first Czech analysis of 1887 cases with monoclonal gammopathy of undetermined significance.
- Author
-
Sandecká V, Hájek R, Pour L, Špička I, Ščudla V, Gregora E, Radocha J, Walterová L, Kessler P, Zahradová L, Adamová D, Valentova K, Vonke I, Obernauerová J, Starostka D, Wróbel M, Brožová L, Jarkovský J, Mikulášová A, Říhová L, Ševčíková S, Straub J, Minařík J, Adam Z, Krejčí M, Král Z, and Maisnar V
- Subjects
- Aged, Aged, 80 and over, Biomarkers, Bone Marrow pathology, Cell Transformation, Neoplastic, Czech Republic epidemiology, Disease Progression, Female, Humans, In Situ Hybridization, Fluorescence, Kaplan-Meier Estimate, Male, Middle Aged, Monoclonal Gammopathy of Undetermined Significance diagnosis, Monoclonal Gammopathy of Undetermined Significance metabolism, Myeloma Proteins metabolism, Plasma Cells metabolism, Plasma Cells pathology, Population Surveillance, Proportional Hazards Models, Registries, Risk Assessment, Risk Factors, Monoclonal Gammopathy of Undetermined Significance epidemiology
- Abstract
Introduction: Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition with a risk of malignant conversion., Patients and Methods: With the aim to estimate the cumulative risk MGUS progression to hematologic malignancies, we analyzed a nationwide population-based cohort of 1887 MGUS patients from the Czech Registry of Monoclonal Gammopathies (RMG) between 2007 and 2013., Results: During the follow-up period (median 4 years; range 0.6-34.8), progression to hematologic malignancies was observed in 8.6% (162 of 1887) of patients. Factors associated with progression were as follows: M-protein concentration ≥1.5 g/dL, pathological sFLC (<0.26 or >1.65) ratio, bone marrow plasma cells (BMPCs) in cytology >5%, immunoparesis, age ≥69 years, and the level of serum hemoglobin at baseline <12.0 g/dL. Combining these factors, we propose a new risk model (CMG model). The risk of progression at 10 years was 1.6%, 16.9%, 22.9%, 39.4%, and 52.3%, respectively, if 0 (reference group), one, two, three, or four to five risk factors are present (P<.001) with HR 63 times higher compared to the reference MGUS group., Conclusion: The new CMG model was established with an advantage for better identification of MGUS patients at low risk., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2017
- Full Text
- View/download PDF