Definition and Clinical Significance of the Monoclonal Gammopathy of Undetermined Significance-Like Phenotype in Patients With Monoclonal Gammopathies

被引：14

作者：

Burgos, Leire ^{[1
]}

Tamariz-Amador, Luis-Esteban ^{[1
]}

Puig, Noemi ^{[2
]}

Cedena, Maria-Teresa ^{[3
]}

Guerrero, Camila ^{[1
]}

Jelinek, Tomas ^{[4
]}

Johnson, Sarah ^{[5
]}

Milani, Paolo ^{[6
,7
]}

Cordon, Lourdes J. ^{[8
]}

Perez, Jose ^{[2
]}

Lasa, Marta ^{[1
]}

Termini, Rosalinda ^{[1
]}

Oriol, Albert ^{[9
,10
]}

Hernandez, Miguel-Teodoro ^{[11
]}

Palomera, Luis ^{[12
]}

Martinez-Martinez, Rafael ^{[13
]}

de la Rubia, Javier ^{[14
]}

de Arriba, Felipe ^{[15
]}

Rios, Rafael ^{[16
]}

Gonzalez, Maria-Esther ^{[17
]}

Gironella, Mercedes ^{[18
]}

Cabanas, Valentin ^{[19
]}

Casanova, Maria ^{[20
]}

Krsnik, Isabel ^{[16
]}

Perez-Montana, Albert ^{[21
]}

Gonzalez-Calle, Veronica ^{[2
]}

Rodriguez-Otero, Paula ^{[1
]}

Maisnar, Vladimir ^{[22
]}

Hajek, Roman ^{[4
]}

Van Rhee, Fritz ^{[5
]}

Jimenez-Zepeda, Victor ^{[23
]}

Palladini, Giovanni ^{[6
,7
]}

Merlini, Giampaolo ^{[6
,7
]}

Orfao, Alberto ^{[24
,25
]}

de la Cruz, Javier ^{[3
]}

Martinez-Lopez, Joaquin ^{[3
]}

Lahuerta, Juan-Jose ^{[3
]}

Rosinol, Laura ^{[26
]}

Blade, Joan ^{[26
]}

Mateos, Maria-Victoria F. ^{[2
]}

San-Miguel, Jesus ^{[1
]}

Paiva, Bruno ^{[1
]}

机构：

[1] Univ Navarra, Clin Univ Navarra, Ctr Invest Med Aplicada, CCUN,DISNA,CIBERONC, Pamplona, Spain

[2] Hosp Univ Salamanca HUSAL, IBSAL, IBMCC, CIBERONC,USAL CSIC, Salamanca, Spain

[3] Hosp Univ 12 Octubre, Hematol Dept, CIBERONC, Inst Invest IMAS12, Madrid, Spain

[4] Univ Hosp Ostrava, Dept Haematooncol, Ostrava, Czech Republic

[5] Univ Arkansas Med Sci, Winthrop P Rockefeller Canc Inst, Myeloma Ctr, Div Hematol Oncol, Little Rock, AR USA

[6] Univ Pavia, Dept Mol Med, Pavia, Italy

[7] Fdn IRCCS Policlin San Matteo, Amyloidosis Res & Treatment Ctr, Pavia, Italy

[8] Hosp Univ La Fe, Valencia, Spain

[9] Hosp Badalona Germans Trias & Pujol, Inst Catala Oncol, Barcelona, Spain

[10] Hosp Badalona Germans Trias & Pujol, Inst Josep Carreras, Barcelona, Spain

[11] Hosp Univ Canarias, Santa Cruz De Tenerife, Spain

[12] Hosp Clin Univ Lozano Blesa, Zaragoza, Spain

[13] Hosp Clin San Carlos, Madrid, Spain

[14] Univ Hosp La Fe, Hematol Dept, Valencia, Spain

[15] Univ Murcia, Hosp Morales Meseguer, IMIB Arrixaca, Murcia, Spain

[16] Hosp Univ Puerta Hierro, Madrid, Spain

[17] Hosp Cabuenes, Gijon, Spain

[18] Univ Hosp Vall Hebron, Dept Hematol, Barcelona, Spain

[19] Univ Murcia, Hosp Clin Univ Virgen Arrixaca, IMIB Arrixaca, Murcia, Spain

[20] Hosp Costa Sol Marbella, Hematol Dept, Marbella, Spain

[21] Hosp Univ Son Espases, Palma De Mallorca, Spain

[22] Charles Univ Hosp, Dept Med Haematol 4, Hradec Kralove, Czech Republic

[23] Univ Calgary, Tom Baker Canc Ctr, Dept Hematol, Calgary, AB, Canada

[24] Univ Salamanca, Hosp Univ Salamanca HUSAL, Canc Res Ctr, Dept Med,IBMCC,USAL CSIC,IBSAL, Salamanca, Spain

[25] Univ Salamanca, Cytometry Serv, CIBERONC, Salamanca, Spain

[26] Hosp Clin Barcelona, IDIBAPS, Dept Hematol, Amyloidosis & Myeloma Unit, Barcelona, Spain

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2023年 / 41卷 / 16期

基金：

欧洲研究理事会;

关键词：

MINIMAL RESIDUAL DISEASE; SMOLDERING MULTIPLE-MYELOMA; FLOW-CYTOMETRY; COMPLETE RESPONSE; STAGING SYSTEM; DEXAMETHASONE; TRANSPLANTATION; LENALIDOMIDE; BORTEZOMIB; SIGNATURE;

D O I：

10.1200/JCO.22.01916

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PURPOSEThe existence of patients with multiple myeloma (MM) and light-chain (AL) amyloidosis who present with a monoclonal gammopathy of undetermined significance (MGUS)-like phenotype has been hypothesized, but methods to identify this subgroup are not standardized and its clinical significance is not properly validated.PATIENTS AND METHODSAn algorithm to identify patients having MGUS-like phenotype was developed on the basis of the percentages of total bone marrow (BM) plasma cells (PC) and of clonal PC within the BM PC compartment, determined at diagnosis using flow cytometry in 548 patients with MGUS and 2,011 patients with active MM. The clinical significance of the algorithm was tested and validated in 488 patients with smoldering MM, 3,870 patients with active MM and 211 patients with AL amyloidosis.RESULTSPatients with smoldering MM with MGUS-like phenotype showed significantly lower rates of disease progression (4.5% and 0% at 2 years in two independent series). There were no statistically significant differences in time to progression between treatment versus observation in these patients. In active newly diagnosed MM, MGUS-like phenotype retained independent prognostic value in multivariate analyses of progression-free survival (PFS; hazard ratio [HR], 0.49; P = .001) and overall survival (OS; HR, 0.56; P = .039), together with International Staging System, lactate dehydrogenase, cytogenetic risk, transplant eligibility, and complete remission status. Transplant-eligible patients with active MM with MGUS-like phenotype showed PFS and OS rates at 5 years of 79% and 96%, respectively. In this subgroup, there were no differences in PFS and OS according to complete remission and measurable residual disease status. Application of the algorithm in two independent series of patients with AL predicted for different survival.CONCLUSIONWe developed an open-access algorithm for the identification of MGUS-like patients with distinct clinical outcomes. This phenotypic classification could become part of the diagnostic workup of MM and AL amyloidosis.

引用

页码：3019 / +

页数：14

共 50 条

[21] Maculopathy in Patients with Monoclonal Gammopathy of Undetermined Significance
Smith, Stephen J.
Johnson, Mark W.
Ober, Michael D.
Comer, Grant M.
Smith, Brian D.
OPHTHALMOLOGY RETINA, 2020, 4 (03): : 300 - 309
[22] What is the significance of monoclonal gammopathy of undetermined significance?
Atkin, Catherine
Richter, Alex
Sapey, Elizabeth
CLINICAL MEDICINE, 2018, 18 (05) : 391 - 396
[23] Overview of monoclonal gammopathies of undetermined significance
Vogt, Robert F.
Marti, Gerald E.
BRITISH JOURNAL OF HAEMATOLOGY, 2007, 139 (05) : 687 - 689
[24] Multimorbidity in patients with monoclonal gammopathy of undetermined significance
Epstein, Mara M.
Zhou, Yanhua
Castaneda-Avila, Maira A.
Cohen, Harvey J.
INTERNATIONAL JOURNAL OF CANCER, 2023, 152 (12) : 2485 - 2492
[25] Monoclonal gammopathies of undetermined significance: a review
Kyle, RA
Rajkumar, SV
IMMUNOLOGICAL REVIEWS, 2003, 194 (01) : 112 - 139
[26] Neuropathies of monoclonal gammopathies of undetermined significance
Kelly, JJ
HEMATOLOGY-ONCOLOGY CLINICS OF NORTH AMERICA, 1999, 13 (06) : 1203 - +
[27] Laboratory testing for monoclonal gammopathies: Focus on monoclonal gammopathy of undetermined significance and smoldering multiple myeloma
Willrich, Maria A. V.
Murray, David L.
Kyle, Robert A.
CLINICAL BIOCHEMISTRY, 2018, 51 : 38 - 47
[28] PLASMA-CELL PHENOTYPE IN MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE
BOCCADORO, M
OMEDE, P
GIARETTA, F
FUSARO, A
FRIERI, R
PILERI, A
BLOOD, 1993, 82 (10) : A559 - A559
[29] MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE AND NEUROPATHY
Ui, J. C.
Tavee, J. O.
MUSCLE & NERVE, 2009, 40 (04) : 694 - 694
[30] Monoclonal gammopathy of undetermined significance (MGUS)
Kyle, RA
BAILLIERES CLINICAL HAEMATOLOGY, 1995, 8 (04): : 761 - 781

← 1 2 3 4 5 →