Defining an Ultra-Low Risk Group in Asymptomatic IgM Monoclonal Gammopathy
We analyzed 171 patients with asymptomatic IgM monoclonal gammopathies (64 with IgM monoclonal gammopathy of undetermined significance—MGUS and 107 with smoldering Waldenström macroglobulinemia - SWM) who had a bone marrow (BM) evaluation performed at diagnosis. Abnormal free-light chain ratio (53%...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/9/2055 |
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| author | David F. Moreno Arturo Pereira Natalia Tovar María Teresa Cibeira Laura Magnano María Rozman Mónica López-Guerra Dolors Colomer Beatriz Martín-Antonio Raquel Jiménez-Segura Ignacio Isola Luis Gerardo Rodríguez-Lobato Aina Oliver-Caldés Mari Pau Mena Laura Rosiñol Joan Bladé Carlos Fernández de Larrea |
| author_facet | David F. Moreno Arturo Pereira Natalia Tovar María Teresa Cibeira Laura Magnano María Rozman Mónica López-Guerra Dolors Colomer Beatriz Martín-Antonio Raquel Jiménez-Segura Ignacio Isola Luis Gerardo Rodríguez-Lobato Aina Oliver-Caldés Mari Pau Mena Laura Rosiñol Joan Bladé Carlos Fernández de Larrea |
| author_sort | David F. Moreno |
| collection | DOAJ |
| description | We analyzed 171 patients with asymptomatic IgM monoclonal gammopathies (64 with IgM monoclonal gammopathy of undetermined significance—MGUS and 107 with smoldering Waldenström macroglobulinemia - SWM) who had a bone marrow (BM) evaluation performed at diagnosis. Abnormal free-light chain ratio (53% vs. 31%) and <i>MYD88</i> mutation prevalence (66% vs. 30%) were higher in patients with SWM. No other differences were found among groups. With a median follow-up of 4.3 years, 14 patients progressed to Waldenström macroglobulinemia, 1 to amyloidosis, and 28 died without progression. The <i>MYD88</i> mutation was found in 53% of patients (available in 160 patients). Multivariate analysis showed that immunoparesis (subhazard ratio—SHR 10.2, 95% confidence interval—CI: 4.2–24.8; <i>p</i> < 0.001) and BM lymphoplasmacytic infiltration ≥ 20% (SHR: 6, 95% CI: 1.6–22.1; <i>p</i> = 0.007) were associated with higher risk of progression. We developed a risk model based on these two risk factors. In the absence of both variables, an ultra-low risk group was identified (SHR 0.1, 95% CI 0.02–0.5; <i>p</i> = 0.004), with 3% and 6% of cumulative incidence of progression at 10 and 20 years, respectively. Bootstrap analysis confirmed the reproducibility of these results. This study finds immunoparesis and BM infiltration as biomarkers of progression as well as a low-risk group of progression in asymptomatic IgM monoclonal gammopathies. |
| first_indexed | 2024-03-10T12:02:00Z |
| format | Article |
| id | doaj.art-9027aec9c3e64d8cb4e4db4b8c8779d1 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T12:02:00Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-9027aec9c3e64d8cb4e4db4b8c8779d12023-11-21T16:55:24ZengMDPI AGCancers2072-66942021-04-01139205510.3390/cancers13092055Defining an Ultra-Low Risk Group in Asymptomatic IgM Monoclonal GammopathyDavid F. Moreno0Arturo Pereira1Natalia Tovar2María Teresa Cibeira3Laura Magnano4María Rozman5Mónica López-Guerra6Dolors Colomer7Beatriz Martín-Antonio8Raquel Jiménez-Segura9Ignacio Isola10Luis Gerardo Rodríguez-Lobato11Aina Oliver-Caldés12Mari Pau Mena13Laura Rosiñol14Joan Bladé15Carlos Fernández de Larrea16Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainInstitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, SpainAmyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainAmyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainInstitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, SpainInstitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, SpainInstitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, SpainInstitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, SpainAmyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainAmyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainAmyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainAmyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainAmyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainAmyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainAmyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainAmyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainAmyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, SpainWe analyzed 171 patients with asymptomatic IgM monoclonal gammopathies (64 with IgM monoclonal gammopathy of undetermined significance—MGUS and 107 with smoldering Waldenström macroglobulinemia - SWM) who had a bone marrow (BM) evaluation performed at diagnosis. Abnormal free-light chain ratio (53% vs. 31%) and <i>MYD88</i> mutation prevalence (66% vs. 30%) were higher in patients with SWM. No other differences were found among groups. With a median follow-up of 4.3 years, 14 patients progressed to Waldenström macroglobulinemia, 1 to amyloidosis, and 28 died without progression. The <i>MYD88</i> mutation was found in 53% of patients (available in 160 patients). Multivariate analysis showed that immunoparesis (subhazard ratio—SHR 10.2, 95% confidence interval—CI: 4.2–24.8; <i>p</i> < 0.001) and BM lymphoplasmacytic infiltration ≥ 20% (SHR: 6, 95% CI: 1.6–22.1; <i>p</i> = 0.007) were associated with higher risk of progression. We developed a risk model based on these two risk factors. In the absence of both variables, an ultra-low risk group was identified (SHR 0.1, 95% CI 0.02–0.5; <i>p</i> = 0.004), with 3% and 6% of cumulative incidence of progression at 10 and 20 years, respectively. Bootstrap analysis confirmed the reproducibility of these results. This study finds immunoparesis and BM infiltration as biomarkers of progression as well as a low-risk group of progression in asymptomatic IgM monoclonal gammopathies.https://www.mdpi.com/2072-6694/13/9/2055IgM MGUSsmoldering Waldenström macroglobulinemiaimmunoparesisbone marrow |
| spellingShingle | David F. Moreno Arturo Pereira Natalia Tovar María Teresa Cibeira Laura Magnano María Rozman Mónica López-Guerra Dolors Colomer Beatriz Martín-Antonio Raquel Jiménez-Segura Ignacio Isola Luis Gerardo Rodríguez-Lobato Aina Oliver-Caldés Mari Pau Mena Laura Rosiñol Joan Bladé Carlos Fernández de Larrea Defining an Ultra-Low Risk Group in Asymptomatic IgM Monoclonal Gammopathy Cancers IgM MGUS smoldering Waldenström macroglobulinemia immunoparesis bone marrow |
| title | Defining an Ultra-Low Risk Group in Asymptomatic IgM Monoclonal Gammopathy |
| title_full | Defining an Ultra-Low Risk Group in Asymptomatic IgM Monoclonal Gammopathy |
| title_fullStr | Defining an Ultra-Low Risk Group in Asymptomatic IgM Monoclonal Gammopathy |
| title_full_unstemmed | Defining an Ultra-Low Risk Group in Asymptomatic IgM Monoclonal Gammopathy |
| title_short | Defining an Ultra-Low Risk Group in Asymptomatic IgM Monoclonal Gammopathy |
| title_sort | defining an ultra low risk group in asymptomatic igm monoclonal gammopathy |
| topic | IgM MGUS smoldering Waldenström macroglobulinemia immunoparesis bone marrow |
| url | https://www.mdpi.com/2072-6694/13/9/2055 |
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