International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM)

被引：172

作者：

Mateos, Maria-Victoria ^{[1
]}

Kumar, Shaji ^{[2
]}

Dimopoulos, Meletios A. ^{[3
]}

Gonzalez-Calle, Veronica ^{[1
]}

Kastritis, Efstathios ^{[3
]}

Hajek, Roman ^{[4
,5
]}

Fernandez De Larrea, Carlos ^{[6
]}

Morgan, Gareth J. ^{[7
]}

Merlini, Giampaolo ^{[8
]}

Goldschmidt, Hartmut ^{[9
,10
]}

Geraldes, Catarina ^{[11
]}

Gozzetti, Alessandro ^{[12
]}

Kyriakou, Charalampia ^{[13
]}

Garderet, Laurent ^{[14
]}

Hansson, Markus ^{[15
]}

Zamagni, Elena ^{[16
]}

Fantl, Dorotea ^{[17
]}

Leleu, Xavier ^{[18
]}

Kim, Byung-Su ^{[19
]}

Esteves, Graca ^{[20
]}

Ludwig, Heinz ^{[21
]}

Usmani, Saad ^{[22
]}

Min, Chang-Ki ^{[23
]}

Qi, Ming ^{[24
]}

Ukropec, Jon ^{[24
]}

Weiss, Brendan M. ^{[24
]}

Rajkumar, S. Vincent ^{[2
]}

Durie, Brian G. M. ^{[25
]}

San-Miguel, Jesus ^{[26
]}

机构：

[1] Univ Salamanca, CSIC, Inst Biol Mol & Cellular Canc, Ctr Invest Canc,Serv Hematol,Hosp Univ Salamanca, Salamanca, Spain

[2] Mayo Clin, Div Hematol, Rochester, MN 55905 USA

[3] Natl & Kapodistrian Univ Athens, Sch Med, Dept Clin Therapeut, Hematol & Med Oncol, Athens, Greece

[4] Ostrava Univ, Fac Med, Ostrava, Czech Republic

[5] Ostrava Univ, Univ Hosp Ostrava, Dept Hematooncol, Ostrava, Czech Republic

[6] Univ Barcelona, Hosp Clin, Dept Hematol, Amyloidosis & Myeloma Unit,IDIBAPS, Barcelona, Spain

[7] NY Langone Hlth, Perlmutter Canc Ctr, New York, NY USA

[8] Univ Pavia, Policlin San Matteo, Fdn Ist Ricovero & Cura Carattere Sci IRCCS, Dept Mol Med,Amyloidosis Res & Treatment Ctr, Pavia, Italy

[9] Univ Med Hosp, Dept Internal Med 5, Heidelberg, Germany

[10] Natl Ctr Tumor Dis, Dept Internal Med 5, Heidelberg, Germany

[11] Ctr Hosp & Univ Coimbra, Dept Clin Hematol, Coimbra, Portugal

[12] Univ Siena, Dept Med Surg & Neurosci, Siena, Italy

[13] London North West Healthcare, Dept Haematol, London, England

[14] Hop La Pitie Salpetriere, Serv Hematol, Paris, France

[15] Goteborg & Skane Univ Hosp, Sahlgrenska Univ Hosp, Dept Hematol, Lund, Sweden

[16] Univ Bologna, Dept Expt Diagnost & Specialty Med DIMES, Bologna, Italy

[17] Hosp Italiano Buenos Aires, Dept Hematol, Buenos Aires, DF, Argentina

[18] CHU, Hop La Miletrie, Poitiers, France

[19] Hallym Univ, Dongtan Sacred Heart Hosp, Dept Hematooncol, Hwasung, South Korea

[20] Hosp Santa Maria, Dept Hematol, Lisbon, Portugal

[21] Wilhelminenspital Stadt Wien, Ctr Oncol Hematol & Palliat Care, Dept Med, Vienna, Austria

[22] Atrium Hlth Levine Canc Inst, Dept Hematol & Med Oncol, Charlotte, NC USA

[23] Catholic Univ Korea, Seoul St Marys Hosp, Dept Internal Med, Hematol, Seoul, South Korea

[24] Janssen Pharmaceut, Horsham, PA USA

[25] Cedars Sinai Outpatient Canc Ctr, Los Angeles, CA USA

[26] Clin Univ Navarra, IDISNA, CIMA, CIBERONC, Pamplona, Spain

来源：

BLOOD CANCER JOURNAL | 2020年 / 10卷 / 10期

关键词：

PROGRESSION; THALIDOMIDE; GAMMOPATHY; CRITERIA; THERAPY;

D O I：

10.1038/s41408-020-00366-3

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Smoldering multiple myeloma (SMM) is an asymptomatic precursor state of multiple myeloma (MM). Recently, MM was redefined to include biomarkers predicting a high risk of progression from SMM, thus necessitating a redefinition of SMM and its risk stratification. We assembled a large cohort of SMM patients meeting the revised IMWG criteria to develop a new risk stratification system. We included 1996 patients, and using stepwise selection and multivariable analysis, we identified three independent factors predicting progression risk at 2 years: serum M-protein >2 g/dL (HR: 2.1), involved to uninvolved free light-chain ratio >20 (HR: 2.7), and marrow plasma cell infiltration >20% (HR: 2.4). This translates into 3 categories with increasing 2-year progression risk: 6% for low risk (38%; no risk factors, HR: 1); 18% for intermediate risk (33%; 1 factor; HR: 3.0), and 44% for high risk (29%; 2-3 factors). Addition of cytogenetic abnormalities (t(4;14), t(14;16), +1q, and/or del13q) allowed separation into 4 groups (low risk with 0, low intermediate risk with 1, intermediate risk with 2, and high risk with >= 3 risk factors) with 6, 23, 46, and 63% risk of progression in 2 years, respectively. The 2/20/20 risk stratification model can be easily implemented to identify high-risk SMM for clinical research and routine practice and will be widely applicable.

引用

页数：11

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