Analysis of modern prognostic factors on cellular and molecular level determining risk of transformation of monoclonal gammopathy of undetermined significance into multiple myeloma [Analýza moderních prognostických faktorů na buněčné a molekulární úrovni určujících riziko transformace monoklonální gamapatie nejasného významu do mnohočetného myelomu]
Rihova L.,Oddeleni Klinicke Hematologie |
Sandecka V.,Interni Hematoonkologicka Klinika |
Klincova M.,Interni Hematoonkologicka Klinika |
Varmuzova T.,Oddeleni Klinicke Hematologie |
And 11 more authors.
Klinicka Biochemie a Metabolismus | Year: 2012
Objective: The creation of the stratification model and identification of high-risk individuals with MGUS, which should be considered to an early therapeutic intervention. Design: The retrospective study Settings: Department of Internal medicine - Hematooncology, University Hospital Brno Material and Methods: The pilot statistical analysis of 314 MGUS subjects from Registry of Monoclonal Gammopathies (RMG) was done. Basic clinical data were used together with existing (type of monoclonal protein - MIG, level of MIG, serum free light chain ratio - FLC ratio) and new prognostic parameters (presence of cytogenetic abnormalities, flow cytometry enumeration of clonal plasma cells and presence of immunoparesis). Results: Higher number of plasma cells according to the morphology and presence of >95 % PC with aberrant phenotype CD19-CD56 +/- as well were more frequently associated with transformation of MGUS into MM (p<0.05). Also, the presence of any immunoparesis and/or immunoparesis affecting both uninvolved immunoglobulins was more frequently detected in transformed MGUS (p=0.001). The first analysis of existing and new prognostic factors in MGUS achieved sensitivity of the stratification about 50 % within 2 years. Conclusion: The significance of morphological and flow cytometry assessment of PCs was confirmed and presence of the immunoparesis plays an important role as well. Model of stratification will be further developed with the aim of achieving 90% sensitivity within 2 years and a similar analysis will be performed also for asymptomatic multiple myeloma (aMM).