Cancer Network
Spotlight
Acute Lymphoblastic LeukemiaAround the PracticeASCO Genitourinary Cancers SymposiumHER2-Positive Breast CancerNon-Small Cell Lung Cancer (NSCLC)Prostate Cancer
Clinical
View MoreBrain CancerBreast CancerColorectal CancerGastrointestinal CancerGenitourinary CancerGynecologic CancerHematologyLeukemiaLung CancerLymphomaPediatric CancersSkin Cancer
News
All NewsNP/PAPractice ManagementTechnology
Media
Around the PracticeClinical ConsultEnduring WebinarsExpert InterviewsK-CastMedical World NewsPodcastsReadout 360Tumor Board Series
Conferences
Publications
About Oncology JournalOncology Journal
Events
Live EventsVirtual Events
CME/CE
Resources
Image IQPollsQuizzesSlideshowsSponsoredToolkits
Subscribe
eNewsletterPrint Subscription

  • CureToday.com
  • OncLive.com
  • TargetedOnc.com
  • Contact
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Personal Information
  • MJHLS Brand Logo

© 2021 MJH Life Sciences and Cancer Network. All rights reserved.

Spotlight
  • Acute Lymphoblastic Leukemia
  • Around the Practice
  • ASCO Genitourinary Cancers Symposium
  • HER2-Positive Breast Cancer
  • Non-Small Cell Lung Cancer (NSCLC)
  • Prostate Cancer
ClinicalSee All >
  • Brain Cancer
  • Breast Cancer
  • Colorectal Cancer
  • Gastrointestinal Cancer
  • Genitourinary Cancer
  • Gynecologic Cancer
  • Hematology
  • Leukemia
  • Lung Cancer
  • Lymphoma
  • Pediatric Cancers
  • Skin Cancer
  • CureToday.com
  • OncLive.com
  • TargetedOnc.com
  • Contact
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Personal Information
  • MJHLS Brand Logo

© 2021 MJH Life Sciences™ and Cancer Network. All rights reserved.

New Data Contradict Previous Ideas About MGUS Risk Status

August 9, 2019
Leah Lawrence
Leah Lawrence

New data push back against previous thinking that an individual's risk of progression from MGUS to multiple myeloma was constant.

New data published in JAMA Oncology suggest that low-risk or intermediate-risk monoclonal gammopathy of unknown significance (MGUS) can convert to high-risk MGUS and progress to multiple myeloma within 5 years. These data are in contrast to previous thinking that suggested that an individual’s risk of progression from MGUS to multiple myeloma was constant.

“This finding is clinically relevant and supports annual blood testing for all individuals diagnosed with MGUS or light-chain MGUS, as well as yearly assessment of a patient’s clinical risk status,” Ola Landgren, MD, PhD, of Memorial Sloan Kettering Cancer Center, and colleagues wrote in JAMA Oncology.

The study used data from the National Cancer Institute Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial that included 187 patients with progressing MGUS and 498 with stable MGUS, including light-chain subtype. Data were from November 1993 to December 2011.

Using cross-sectional modeling, Landgren and colleagues identified several risk factors associated with progressive MGUS: IgA isotype (adjusted odds ratio=1.80; 95% CI, 1.03–3.13; P=.04), 15 g/L or more monoclonal spike (aOR=23.5; 95% CI, 8.9–61.9; P<.001), skewed serum free light chains ratio (aOR=46.4; 95% CI, 18.4–117.0; P<.001), and severe immunoparesis (adOR=19.1; 95% CI, 7.5–48.3; P<.001).

Those factors associated with progressive light-chain MGUS were skewed free light chains ratio (aOR-44.0; 95% CI, 14.2–136.3; P<.001) and severe immunoparesis (aOR=48.6; 95% CI, 9.5–248.2; P<.001).

Among those patients with serial blood samples taken prior to disease progression, more than half (53%) had high-risk MGUS before progression. Of those with high risk, 70% had a conversion from low-risk or intermediate-risk MGUS within the prior 5 years. Among patients with light-chain MGUS who had high-risk status before multiple myeloma diagnosis, 71% had prior blood samples showing low-risk or intermediate-risk scores.

In an accompanying editorial, Nikhil C. Munshi, MD, of Dana-Farber Cancer Institute, and colleagues wrote that if the findings by Landgren et al. are confirmed in other studies, “it would require rethinking of our strategy to follow these patients, as well as development of strategies to prevent progression, not only in high-risk patients, but also in patients at intermediate to low risk of progression.”

“This study by Landgren et al. provides an important and biologically relevant concept that risk features are not stagnant, and that patients with MGUS may evolve over time, with the disease developing more aggressive characteristics prior to proceeding to developing malignant transformation,” Munshi and colleagues wrote. “An ongoing question would be: can we identify those patients in each of the risk categories who have extremely low chance of progression? In this regard, studying the patients’ genomics, especially the ability to evolve over time, may be critical in understanding this biological transformation with significant implications for therapy and patient treatment.”

Related Content:

Multiple Myeloma
KarMMa Trial Results for Ide-Cel in Refractory Myeloma Show Favorable Efficacy

KarMMa Trial Results for Ide-Cel in Refractory Myeloma Show Favorable Efficacy

Previous Cancer Diagnoses Associated with Subsequent Development of Multiple Myeloma

Previous Cancer Diagnoses Associated with Subsequent Development of Multiple Myeloma

Daratumumab Combo Improves PROs for Patients with Newly Diagnosed MM

Daratumumab Combo Improves PROs for Patients with Newly Diagnosed MM