A first Czech analysis of 1887 cases with monoclonal gammopathy of undetermined significance

Autoři	SANDECKÁ Viera HÁJEK Roman POUR Luděk SPICKA I. SCUDLA V. GREGORA E. RADOCHA J. WALTEROVA L. KESSLER P. ZAHRADOVA L. ADAMOVA D. VALENTOVA K. VONKE I. OBERNAUEROVA J. STAROSTKA D. WROBEL M. BROŽOVÁ Lucie JARKOVSKÝ Jiří MIKULÁŠOVÁ Aneta RIHOVA L. ŠEVČÍKOVÁ Sabina STRAUB J. MINARIK J. ADAM Zdeněk KREJČÍ Marta KRÁL Zdeněk MAISNAR V.
Rok publikování	2017
Druh	Článek v odborném periodiku
Časopis / Zdroj	European Journal of Haematology
Fakulta / Pracoviště MU	Lékařská fakulta
Citace
Doi	http://dx.doi.org/10.1111/ejh.12894
Obor	Onkologie a hematologie
Klíčová slova	monoclonal gammopathy; multiple myeloma; progression; risk factors
Popis	IntroductionMonoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition with a risk of malignant conversion. Patients and methodsWith the aim to estimate the cumulative risk MGUS progression to hematologic malignancies, we analyzed a nationwide population-basedcohort of 1887 MGUS patients from the Czech Registry of Monoclonal Gammopathies (RMG) between 2007 and 2013. ResultsDuring the follow-up period (median 4years; 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 1.5g/dL, pathological sFLC (<0.26 or >1.65) ratio, bone marrow plasma cells (BMPCs) in cytology >5%, immunoparesis, age 69years, and the level of serum hemoglobin at baseline <12.0g/dL. Combining these factors, we propose a new risk model (CMG model). The risk of progression at 10years 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. ConclusionThe new CMG model was established with an advantage for better identification of MGUS patients at low risk.