Prognostic risk and survival of asymptomatic IgM monoclonal gammopathy: Results from a Spanish Multicenter Registry
Abstract Asymptomatic IgM gammopathy encompasses IgM monoclonal gammopathy of undetermined significance (MGUS) and asymptomatic Waldenström macroglobulinemia (AWM), both having a risk of progression to symptomatic disease. Here, we assessed the risk of progression and the mortality of 956 patients w...
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Wiley
2024-11-01
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| Series: | HemaSphere |
| Online Access: | https://doi.org/10.1002/hem3.70029 |
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| author | David F. Moreno Cristina Jiménez Fernando Escalante Elham Askari Marta Castellanos‐Alonso Mario Arnao Ángela Heredia Miguel Á. Canales Magdalena Alcalá Arancha Bermúdez Ana Saus Carreres María Casanova Luis Palomera Cristina Motlló Ricarda García‐Sánchez Pablo Ríos Rull Ramón García‐Sanz Carlos Fernández de Larrea |
| author_facet | David F. Moreno Cristina Jiménez Fernando Escalante Elham Askari Marta Castellanos‐Alonso Mario Arnao Ángela Heredia Miguel Á. Canales Magdalena Alcalá Arancha Bermúdez Ana Saus Carreres María Casanova Luis Palomera Cristina Motlló Ricarda García‐Sánchez Pablo Ríos Rull Ramón García‐Sanz Carlos Fernández de Larrea |
| author_sort | David F. Moreno |
| collection | DOAJ |
| description | Abstract Asymptomatic IgM gammopathy encompasses IgM monoclonal gammopathy of undetermined significance (MGUS) and asymptomatic Waldenström macroglobulinemia (AWM), both having a risk of progression to symptomatic disease. Here, we assessed the risk of progression and the mortality of 956 patients with asymptomatic IgM gammopathy across 25 Spanish centers. After a median follow‐up of 5.7 years, 156 patients progressed, most of them to symptomatic WM (SWM). The cumulative incidence of progression was 13% and 20% at 5 and 10 years, respectively. The serum IgM ≥10 g/L, bone marrow (BM) infiltration ≥20%, β2‐microglobulin ≥3 mg/L, and albumin <4 g/dL were the most potent predictors of disease progression in a multivariate Cox regression model, allowing the identification of three risk categories. The probability of progression to symptomatic disease at 5 years was 4.5%, 15.7%, and 42.8% for low‐, intermediate‐, and high‐risk groups, respectively. In patients without a BM evaluation, the presence of none or 1 risk factor and 2 or 3 risk factors conferred a progression risk of 6% and 27% at 5 years, respectively. The model was independent of the presence of MYD88 L265P, which conferred a negative impact only in AWM patients. The relative survival (RS) ratio at 5 years of asymptomatic patients was similar to the Spanish population, which contrasted with the 0.76 5‐year RS of SWM patients. Overall, the Spanish Multicenter Model comprehensively describes the risk of progression of asymptomatic patients and shows that the excess mortality is increased only in the symptomatic stage of the disease. |
| format | Article |
| id | doaj-art-d1576f3dca1d4a12bd8dfab3c2b19f33 |
| institution | Kabale University |
| issn | 2572-9241 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
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| series | HemaSphere |
| spelling | doaj-art-d1576f3dca1d4a12bd8dfab3c2b19f332024-11-26T10:54:29ZengWileyHemaSphere2572-92412024-11-01811n/an/a10.1002/hem3.70029Prognostic risk and survival of asymptomatic IgM monoclonal gammopathy: Results from a Spanish Multicenter RegistryDavid F. Moreno0Cristina Jiménez1Fernando Escalante2Elham Askari3Marta Castellanos‐Alonso4Mario Arnao5Ángela Heredia6Miguel Á. Canales7Magdalena Alcalá8Arancha Bermúdez9Ana Saus Carreres10María Casanova11Luis Palomera12Cristina Motlló13Ricarda García‐Sánchez14Pablo Ríos Rull15Ramón García‐Sanz16Carlos Fernández de Larrea17Hematology Department, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona SpainHematology Department University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), Accelerator project, Centro de Investigación Biomédica en Red‐Cáncer (CIBERONC) CB16/12/00369 and Center for Cancer Research‐IBMCC (USAL‐CSIC) Salamanca SpainHematology Department Unidad i + i, Complejo Asistencial Universitario de León León SpainHematology Department Hospital Universitario Fundación Jiménez Díaz Madrid SpainHematology Department Unidad i + i, Complejo Asistencial Universitario de León León SpainHematology Department, Hospital La Fe Centro de Investigación Biomédica en Red‐Cáncer (CIBERONC) Valencia SpainHematology Department Hospital Virgen de la Arrixaca, IMIB Murcia SpainHematology Department Clínica Universidad de Navarra, Centro de Investigación Biomédica en Red‐Cáncer (CIBERONC) Pamplona SpainHematology Department Hospital Regional Universitario de Málaga Málaga SpainHematology Department University Hospital Marqués de Valdecilla, IDIVAL Santander SpainHematology Department Hospital Clínico Universitario Valencia SpainHematology Department Hospital Costa del Sol Marbella Marbella SpainHematology Department Hospital Clínico Lozano Blesa Zaragoza SpainHematology Department Hospital Sant Joan de Déu‐Fundació Althaia Manresa SpainHematology Department Hospital Virgen de la Victoria Málaga SpainHematology Department Hospital Nuestra Señora de la Candelaria Canarias SpainHematology Department University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), Accelerator project, Centro de Investigación Biomédica en Red‐Cáncer (CIBERONC) CB16/12/00369 and Center for Cancer Research‐IBMCC (USAL‐CSIC) Salamanca SpainHematology Department, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona SpainAbstract Asymptomatic IgM gammopathy encompasses IgM monoclonal gammopathy of undetermined significance (MGUS) and asymptomatic Waldenström macroglobulinemia (AWM), both having a risk of progression to symptomatic disease. Here, we assessed the risk of progression and the mortality of 956 patients with asymptomatic IgM gammopathy across 25 Spanish centers. After a median follow‐up of 5.7 years, 156 patients progressed, most of them to symptomatic WM (SWM). The cumulative incidence of progression was 13% and 20% at 5 and 10 years, respectively. The serum IgM ≥10 g/L, bone marrow (BM) infiltration ≥20%, β2‐microglobulin ≥3 mg/L, and albumin <4 g/dL were the most potent predictors of disease progression in a multivariate Cox regression model, allowing the identification of three risk categories. The probability of progression to symptomatic disease at 5 years was 4.5%, 15.7%, and 42.8% for low‐, intermediate‐, and high‐risk groups, respectively. In patients without a BM evaluation, the presence of none or 1 risk factor and 2 or 3 risk factors conferred a progression risk of 6% and 27% at 5 years, respectively. The model was independent of the presence of MYD88 L265P, which conferred a negative impact only in AWM patients. The relative survival (RS) ratio at 5 years of asymptomatic patients was similar to the Spanish population, which contrasted with the 0.76 5‐year RS of SWM patients. Overall, the Spanish Multicenter Model comprehensively describes the risk of progression of asymptomatic patients and shows that the excess mortality is increased only in the symptomatic stage of the disease.https://doi.org/10.1002/hem3.70029 |
| spellingShingle | David F. Moreno Cristina Jiménez Fernando Escalante Elham Askari Marta Castellanos‐Alonso Mario Arnao Ángela Heredia Miguel Á. Canales Magdalena Alcalá Arancha Bermúdez Ana Saus Carreres María Casanova Luis Palomera Cristina Motlló Ricarda García‐Sánchez Pablo Ríos Rull Ramón García‐Sanz Carlos Fernández de Larrea Prognostic risk and survival of asymptomatic IgM monoclonal gammopathy: Results from a Spanish Multicenter Registry HemaSphere |
| title | Prognostic risk and survival of asymptomatic IgM monoclonal gammopathy: Results from a Spanish Multicenter Registry |
| title_full | Prognostic risk and survival of asymptomatic IgM monoclonal gammopathy: Results from a Spanish Multicenter Registry |
| title_fullStr | Prognostic risk and survival of asymptomatic IgM monoclonal gammopathy: Results from a Spanish Multicenter Registry |
| title_full_unstemmed | Prognostic risk and survival of asymptomatic IgM monoclonal gammopathy: Results from a Spanish Multicenter Registry |
| title_short | Prognostic risk and survival of asymptomatic IgM monoclonal gammopathy: Results from a Spanish Multicenter Registry |
| title_sort | prognostic risk and survival of asymptomatic igm monoclonal gammopathy results from a spanish multicenter registry |
| url | https://doi.org/10.1002/hem3.70029 |
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