Smoldering multiple myeloma risk factors for progression: a Danish population-based cohort study

TY - JOUR

T1 - Smoldering multiple myeloma risk factors for progression

T2 - a Danish population-based cohort study

AU - Sørrig, Rasmus

AU - Klausen, Tobias W

AU - Salomo, Morten

AU - Vangsted, Annette J

AU - Østergaard, Brian

AU - Gregersen, Henrik

AU - Frølund, Ulf Christian

AU - Andersen, Niels F

AU - Helleberg, Carsten

AU - Andersen, Kristian Thidemann

AU - Pedersen, Robert Schou

AU - Pedersen, Per

AU - Abildgaard, Niels

AU - Gimsing, Peter

AU - Danish Myeloma Study Group

N1 - © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Several risk scores for disease progression in patients with smoldering multiple myeloma (SMM) have been proposed; however, all have been developed using single-center registries. To examine risk factors for time to progression (TTP) to multiple myeloma (MM) for SMM, we analyzed a nationwide population-based cohort of 321 patients with newly diagnosed SMM registered within the Danish Multiple Myeloma Registry between 2005 and 2014. Significant univariable risk factors for TTP were selected for multivariable Cox regression analyses. We found that both an M-protein ≥30 g/L and immunoparesis significantly influenced TTP (HR 2.7, 95%CI (1.5;4.7), P = 0.001, and HR 3.3, 95%CI (1.4;7.8), P = 0.002, respectively). High free light chain (FLC) ratio did not significantly influence TTP in our cohort. Therefore, our data do not support recent IMWG proposal of identifying patients with FLC ratio above 100 as having ultra high-risk of transformation to MM. Using only immunoparesis and M-protein ≥30 g/L, we created a scoring system to identify low-, intermediate-, and high-risk SMM. This first population-based study of patients with SMM confirms that an M-protein ≥30 g/L and immunoparesis remain important risk factors for progression to MM.

AB - Several risk scores for disease progression in patients with smoldering multiple myeloma (SMM) have been proposed; however, all have been developed using single-center registries. To examine risk factors for time to progression (TTP) to multiple myeloma (MM) for SMM, we analyzed a nationwide population-based cohort of 321 patients with newly diagnosed SMM registered within the Danish Multiple Myeloma Registry between 2005 and 2014. Significant univariable risk factors for TTP were selected for multivariable Cox regression analyses. We found that both an M-protein ≥30 g/L and immunoparesis significantly influenced TTP (HR 2.7, 95%CI (1.5;4.7), P = 0.001, and HR 3.3, 95%CI (1.4;7.8), P = 0.002, respectively). High free light chain (FLC) ratio did not significantly influence TTP in our cohort. Therefore, our data do not support recent IMWG proposal of identifying patients with FLC ratio above 100 as having ultra high-risk of transformation to MM. Using only immunoparesis and M-protein ≥30 g/L, we created a scoring system to identify low-, intermediate-, and high-risk SMM. This first population-based study of patients with SMM confirms that an M-protein ≥30 g/L and immunoparesis remain important risk factors for progression to MM.

KW - Aged

KW - Biomarkers, Tumor

KW - Denmark

KW - Disease Progression

KW - Female

KW - Humans

KW - Immunoglobulin Light Chains

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Multiple Myeloma

KW - Myeloma Proteins

KW - Paraproteinemias

KW - Population Surveillance

KW - Prognosis

KW - Risk Factors

KW - Journal Article

U2 - 10.1111/ejh.12728

DO - 10.1111/ejh.12728

M3 - Journal article

C2 - 26710662

SN - 0902-4441

VL - 97

SP - 303

EP - 309

JO - European Journal of Haematology

JF - European Journal of Haematology

IS - 3

ER -