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MGUS Immune Markers Predict Risk of Progression to Multiple Myeloma

Multiple myeloma drawing shows normal plasma cells, multiple myeloma cells (abnormal plasma cells), and antibodies. Also shown is red marrow inside bone, where plasma cells are made.

Multiple myeloma is a cancer that affects plasma cells, a type of white blood cell that produces antibodies to fight infection and disease.

An analysis of data from a longitudinal prospective study has identified levels of Monoclonal Gammopathy of Undetermined Significance (MGUS) immune markers measured in blood predict an individual’s risk for developing multiple myeloma, a rare cancer arising in the bone marrow. These findings were published July 18, 2019, in JAMA Oncology.

Multiple myeloma is consistently preceded by a largely asymptomatic condition known as MGUS, which is detectable in peripheral blood (Langdren, O. et al., 2009). However, relatively few individuals with MGUS will go on to develop multiple myeloma (between 0.5% - 1.0% per year). While it has been suggested that changes in MGUS immune marker levels correlate with progression to multiple myeloma, current risk estimation models are based on data from a single time point. 

This new study, a collaborative effort co-led by Drs. Jonathan Hofmann, Ph.D., M.P.H., (DCEG) and Ola Landgren (Memorial Sloan Kettering Cancer Center) followed 685 individuals diagnosed with MGUS using data from the Prostate, Lung, Colorectal, Ovarian (PLCO) Cancer Screening Trial and tracked fluctuations in their marker levels over time. Using a scoring system based on several characteristics of MGUS, individuals were classified as having a low, intermediate, or high risk of progression to multiple myeloma. The authors determined low-to-intermediate-risk MGUS can transform into high-risk MGUS and progress to multiple myeloma within five years, and that the risk of progression is not necessarily constant over time. These findings support the need for annual blood testing for MGUS patients, and yearly reassessment of a patient’s clinical risk status.  
 

Reference:

Landgren, O., Hofmann, J.N., et al. Association of Immune Marker Changes With Progression of Monoclonal Gammopathy of Undetermined Significance to Multiple Myeloma. JAMA Oncology. June 18, 2019. DOI: 10.1001/jamaoncol.2019.1568. [Epub ahead of print]

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