Immunoglobulin free light chain ratio is an independent risk factor for progression of smoldering (asymptomatic) multiple myeloma

Dispenzieri, Angela; Kyle, Robert A.; Katzmann, Jerry A.; Therneau, Terry M.; Larson, Dirk R.; Benson, Joanne T.; Clark, Raynell J.; Melton, L. Joseph; Gertz, Morie A.; Kumar, Shaji; Fonseca, Rafaël; Jelinek, Diane F.; Rajkumar, S. Vincent

doi:10.1182/blood-2007-08-108357

Cited by 361 publications

(322 citation statements)

References 30 publications

Supporting

Mentioning

300

Contrasting

Unclassified

Order By: Relevance

“…8,12,15 Our results document that B2M improves the risk stratification model defined by sMC, uMC, and BMPC percentage by adding information both in the low-risk stratum and in the high-risk stratum of patients with asymptomatic MM. In fact, B2M contributes to identifying a group of patients who have asymptomatic MM with a very favorable prognosis who are not expected to progress and a group of high-risk patients with asymptomatic MM virtually all of whom are projected to progress.…”

Section: Discussionsupporting

confidence: 55%

“…8,12,15 Consistent with previous observations, sMC, uMC, and BMPC percentage were selected as predictors of progression in our asymptomatic MM cohort. When combined into a model, sMC, uMC, and BMPC percentage allowed us to stratify patients into 3 risk categories (Fig.…”

Section: Beta-2-microglobulin Improves the Risk Stratification Of Asymentioning

confidence: 72%

“…To date, none of the previous studies on asymptomatic MM focused on B2M, [3][4][5][6][7][8][9][10][11][12][13][14][15] and only 2 reports included B2M among baseline variables. 7,10 In the study by Moulopoulos et al, 7 patients with asymptomatic MM who presented with B2M >2.5 mg/L had a short time to progression to symptomatic disease.…”

Section: Discussionmentioning

confidence: 99%

“…8,15 Because serum FLC levels have entered the routine clinical practice only recently, this information was not available for the current analysis. On this basis, in our cohort, the baseline serum FLC burden was estimated indirectly by measuring BJ proteinuria.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8][9][10][11][12][13][14][15] Therefore, in the current study, we investigated a cohort of patients who had asymptomatic MM to verify 1) whether B2M levels predict progression to symptomatic MM and 2) how B2M interacts with currently known predictors of progression to symptomatic MM.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Beta‐2‐microglobulin is an independent predictor of progression in asymptomatic multiple myeloma

Rossi

Fangazio

Paoli

et al. 2010

Cancer

View full text Add to dashboard Cite

BACKGROUND: Although serum beta-2 microglobulin (B2M) represents a key variable for symptomatic multiple myeloma (MM) prognostication, its role in predicting the risk of progression of asymptomatic MM to symptomatic disease has not been explored. METHODS: This study was bases on a consecutive series of 148 patients with asymptomatic MM and explored the cumulative probability of progression to symptomatic MM as the primary endpoint. RESULTS: In univariate analysis, a serum B2M level >2.5 mg/L was associated with an increased probability of disease progression (5-year risk, 64.5%; P < .001) along with serum monoclonal component (sMC) (P < .001), urinary monoclonal component (uMC) (P < .001), and bone marrow plasma cells (BMPCs) (P < .001). In multivariate analysis, serum B2M was selected as an independent predictor of progression (hazard ratio, 3.30; P ¼.002). Serum B2M was combined with sMC, uMC, and BMPC to create a risk-stratification model based on 4 groups with different risk of progression: very low (5-year risk, 0%), low-intermediate (5-year risk, 19.6%), high-intermediate (5-year risk, 60.7%), and high (5-year risk, 80.7%). The model that included serum B2M along with sMC, uMC, and BMPC was able to predict disease progression better than the model that was based on sMC, uMC, and BMPC without serum B2M (C statistics, 0.760 vs 0.726). CONCLUSIONS: The current results indicated that 1) serum B2M is an independent predictor of asymptomatic MM progression, and 2) serum B2M adds prognostic information when combined with the most widely used prognosticators of asymptomatic MM progression.

show abstract

Section: Discussionsupporting

confidence: 55%

Section: Beta-2-microglobulin Improves the Risk Stratification Of Asymentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Beta‐2‐microglobulin is an independent predictor of progression in asymptomatic multiple myeloma

Rossi

Fangazio

Paoli

et al. 2010

Cancer

View full text Add to dashboard Cite

show abstract

Multiple Myeloma Precursor Disease

Landgren¹,

Waxman²

2010

JAMA

View full text Add to dashboard Cite

Recent data indicate that multiple myeloma is consistently preceded by the precursor states of monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma. Currently, multiple myeloma is a clinical diagnosis based on manifestations including hypercalcemia, renal failure, anemia, and bone lesions, whereas MGUS and smoldering myeloma are diagnosed based on laboratory abnormalities. Current clinical markers allow for more individualized risk stratification and counseling of these patients. However, there is a dearth of biomarkers and molecular imaging techniques capable of (1) accurately identifying patients with disease biology corresponding with high risk of progression; (2) elucidating the mechanism of transformation to multiple myeloma; and (3) forming a framework for development of targeted therapies. This case presentation and review discusses the current understanding of myeloma precursor disease and future opportunities for improving personalized management of patients with MGUS or smoldering myeloma, as well as the potential for developing early treatment strategies designed to delay and prevent development of multiple myeloma.

show abstract

Treatment With Carfilzomib-Lenalidomide-Dexamethasone With Lenalidomide Extension in Patients With Smoldering or Newly Diagnosed Multiple Myeloma

et al. 2015

View full text Add to dashboard Cite

show abstract

Immunoglobulin free light chain ratio is an independent risk factor for progression of smoldering (asymptomatic) multiple myeloma

Cited by 361 publications

References 30 publications

Beta‐2‐microglobulin is an independent predictor of progression in asymptomatic multiple myeloma

Beta‐2‐microglobulin is an independent predictor of progression in asymptomatic multiple myeloma

Multiple Myeloma Precursor Disease

Treatment With Carfilzomib-Lenalidomide-Dexamethasone With Lenalidomide Extension in Patients With Smoldering or Newly Diagnosed Multiple Myeloma

Contact Info

Product

Resources

About