Longitudinal assessment of established risk stratification models in patients with monoclonal gammopathy of undetermined significance.

IF 12.9 1区 医学 Q1 HEMATOLOGY
Kosima Zuern, Thomas Hielscher, Annika Werly, Iris Breitkreutz, Sandra Sauer, Marc S Raab, Carsten Müller-Tidow, Hartmut Goldschmidt, Elias K Mai
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Abstract

Risk of progression of monoclonal gammopathy of undetermined significance (MGUS) into multiple myeloma and related plasma cell disorders can be determined by three major risk stratification models, namely Mayo2005, Sweden2014, and NCI2019. This retrospective study of 427 patients with MGUS diagnosed according to the 2014 International Myeloma Working Group criteria aimed to describe and analyze the longitudinal applicability of these risk models. In all three models, the majority of patients remained at their baseline risk group, whereas small numbers of patients migrated to a different risk group. Proportions of patients among risk groups remained stable over time (e.g. Mayo2005 model, low-risk group, at baseline: 43%, after 1, 2, 3, 4, 5, and 8 years: 40%, 37%, 37%, 43%, 44%, and 43%). All three risk models reliably distinguished risk of progression at baseline, upon yearly reassessment (e.g. 1 year from diagnosis) and in time-dependent analyses. Upstaging to a high-risk category was associated with an increased risk of progression in all three models (Mayo2005: hazard ratio [HR] = 5.43, 95% confidence interval [95% CI] 1.21-24.39, p = 0.027; Sweden2014: HR = 13.02, 95% CI 5.25-32.28, p < 0.001; NCI2019: HR = 5.85, 95% CI 2.49-13.74, p < 0.001). Our study shows that MGUS risk stratification models can be applied longitudinally to repeatedly determine and improve individual risk of progression. Patient migration to higher risk categories during follow up should prompt more frequent monitoring in clinical routine.

Abstract Image

对意义未定的单克隆丙种球蛋白病患者的既定风险分层模型进行纵向评估。
意义未定的单克隆丙种球蛋白病(MGUS)进展为多发性骨髓瘤和相关浆细胞疾病的风险可由三种主要风险分层模型确定,即Mayo2005、Sweden2014和NCI2019。这项对根据2014年国际骨髓瘤工作组标准确诊的427例MGUS患者进行的回顾性研究旨在描述和分析这些风险模型的纵向适用性。在所有三种模型中,大多数患者仍处于基线风险组别,而少数患者则转移到了不同的风险组别。随着时间的推移,风险组别中的患者比例保持稳定(例如,Mayo2005 模型,低风险组,基线时:43%,1、2、3、4、5 和 8 年后:40%、37%、37%、43%、44% 和 43%)。所有三种风险模型都能可靠地区分基线时、每年重新评估时(如诊断后 1 年)和随时间变化的分析中的进展风险。在所有三个模型中,升级到高风险类别与进展风险增加有关(Mayo2005:危险比 [HR] = 5.43,95% 置信区间 [95% CI] 1.21-24.39,p = 0.027;Sweden2014:危险比 [HR] = 13.02,95% 置信区间 [95% CI] 1.21-24.39,p = 0.027):HR=13.02,95% CI 5.25-32.28,p
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来源期刊
CiteScore
16.70
自引率
2.30%
发文量
153
审稿时长
>12 weeks
期刊介绍: Blood Cancer Journal is dedicated to publishing high-quality articles related to hematologic malignancies and related disorders. The journal welcomes submissions of original research, reviews, guidelines, and letters that are deemed to have a significant impact in the field. While the journal covers a wide range of topics, it particularly focuses on areas such as: Preclinical studies of new compounds, especially those that provide mechanistic insights Clinical trials and observations Reviews related to new drugs and current management of hematologic malignancies Novel observations related to new mutations, molecular pathways, and tumor genomics Blood Cancer Journal offers a forum for expedited publication of novel observations regarding new mutations or altered pathways.
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