Comparative evaluation of involved free light chain and monoclonal spike as markers for progression from monoclonal gammopathy of undetermined significance to multiple myeloma.
Comparative evaluation of involved free light chain and monoclonal spike as markers for progression from monoclonal gammopathy of undetermined significance to multiple myeloma.
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DOI：
10.1002/ajh.25999
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发表时间：
2021-01
影响因子：
12.8
通讯作者：
Nahi H
中科院分区：
文献类型：
--
作者：
Gran C;Liwing J;Wagner AK;Verhoek A;Gezin A;Alici E;Nahi H
未确定意义的单克隆伽玛病（MGUS）是一种恶性前克隆浆细胞疾病，每年有1%的风险进展为多发性骨髓瘤（MM）。随访期间M - spike和血清游离轻链（sFLC）的演变可以识别进展高风险的患者。在这项全区域范围的研究中，包括4756名个体，确定了987名MGUS患者，并评估了基线因素以及演变相关FLC （iFLC）作为MGUS向MM进展风险的潜在标志物。此外，每季度评估一次演变的iFLC和M - spike，中位时间为5年。在基线时，进展患者的iFLC明显高于非进展患者。M - spike≥1.5 g/dL、年龄≥65岁、iFLC≥100 mg/L的危险因素均与MGUS向MM进展的风险增加独立相关。对于具有任何两种或三种危险因素的患者，5年累积进展概率（31%）明显高于无危险因素（2%）。随访期间iFLC浓度≥100 mg/L始终与进展风险增加相关。根据我们的观察，我们建议将iFLC作为所有MGUS患者的监测工具。此外，我们建议对所有高危患者进行季度监测。最后，我们建议MGUS进展的风险应根据年龄、M - spike和基线时的iFLC进行分层。
Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant clonal plasma cell disorder, with a 1% yearly risk of progression to multiple myeloma (MM). Evolution of M‐spike and serum free light chain (sFLC) during follow‐up could identify patients at high risk of progression. In this region‐wide study, including 4756 individuals, 987 patients with MGUS were identified, and baseline factors as well as evolving involved FLC (iFLC) were evaluated as potential markers for risk of progression from MGUS to MM. Furthermore, evolving iFLC and M‐spike were assessed quarterly for a median of 5 years. At baseline, patients that progressed had significantly higher iFLC compared to non‐progressors. The risk factors of M‐spike >1.5 g/dL, age >65 years and iFLC >100 mg/L were all independently associated with increased risk of MGUS to MM progression. For patients that had any two or three risk factors, the 5‐year cumulative probability of progression was significantly higher (31%) compared to no risk factors (2%). Evolving iFLC >100 mg/L during follow‐up was consistently associated with increased risk of progression. Based on our observations, we propose to include iFLC as a monitoring tool for all MGUS patients. Furthermore, we recommend a quarterly monitoring in all high‐risk patients. Finally, we suggest that the risk of MGUS progression should be stratified with age, M‐spike, and iFLC at baseline.
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影响因子：
6.5
作者：
BLADE, J;LOPEZGUILLERMO, A;MONTSERRAT, E
通讯作者：
MONTSERRAT, E
影响因子：
11.4
作者：
Durie, B. G. M.;Harousseau, J-L;Rajkumar, S. V.
通讯作者：
Rajkumar, S. V.
DOI：
10.1046/j.1468-0734.2002.00076.x
发表时间：
2002-09-01
期刊：
Reviews in clinical and experimental hematology
影响因子：
--
作者：
Kyle, Robert A;Rajkumar, S Vincent
通讯作者：
Rajkumar, S Vincent
影响因子：
12.8
作者：
Ravi, P.;Kumar, S.;Rajkumar, S. V.
通讯作者：
Rajkumar, S. V.
影响因子：
9.3
作者：
Katzmann JA;Kyle RA;Benson J;Larson DR;Snyder MR;Lust JA;Rajkumar SV;Dispenzieri A
通讯作者：
Dispenzieri A