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Prognostic value of circulating plasma cells in monoclonal gammopathy of undetermined significance.
J Clin Oncol. 2005 Aug 20; 23(24):5668-74.JC

Abstract

PURPOSE

Monoclonal gammopathy of undetermined significance (MGUS) progresses to multiple myeloma or another related plasma cell disorder (PCD) at a rate of approximately 1% per year. Identification of patients with MGUS at high risk of progression will allow development of preventive strategies. We studied the prognostic value of circulating plasma cells (PCs) in patients with MGUS to predict progression.

PATIENTS AND METHODS

Patients were eligible for this retrospective analysis if they were seen at the Mayo Clinic between 1984 and 1997, were diagnosed with MGUS, and had an analysis of the peripheral blood for circulating PCs by the slide-based immunofluorescence method. Patients were observed for progression to another PCD.

RESULTS

Three hundred twenty-five patients were eligible and 63 (19%) had circulating PCs. Patients with circulating PCs were twice as likely (hazard ratio, 2.1) to experience progression to another PCD (most commonly myeloma), compared with those without circulating PCs (95% CI, 1.1 to 4.3; P = .03). In patients with circulating PCs, the median progression-free survival was 138 months compared with a median not yet reached for those without circulating PCs (P = .028). The median overall survival also was shorter for those with circulating PCs. Other factors with prognostic value were high levels of M protein and non-immunoglobulin G heavy-chain type.

CONCLUSION

The presence of circulating PCs, especially when combined with other known prognostic factors such as M protein concentration and immunoglobulin isotype, identify a group of individuals with MGUS at higher risk of progression to overt multiple myeloma.

Authors+Show Affiliations

Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

16110026

Citation

Kumar, Shaji, et al. "Prognostic Value of Circulating Plasma Cells in Monoclonal Gammopathy of Undetermined Significance." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 23, no. 24, 2005, pp. 5668-74.
Kumar S, Rajkumar SV, Kyle RA, et al. Prognostic value of circulating plasma cells in monoclonal gammopathy of undetermined significance. J Clin Oncol. 2005;23(24):5668-74.
Kumar, S., Rajkumar, S. V., Kyle, R. A., Lacy, M. Q., Dispenzieri, A., Fonseca, R., Lust, J. A., Gertz, M. A., Greipp, P. R., & Witzig, T. E. (2005). Prognostic value of circulating plasma cells in monoclonal gammopathy of undetermined significance. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 23(24), 5668-74.
Kumar S, et al. Prognostic Value of Circulating Plasma Cells in Monoclonal Gammopathy of Undetermined Significance. J Clin Oncol. 2005 Aug 20;23(24):5668-74. PubMed PMID: 16110026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of circulating plasma cells in monoclonal gammopathy of undetermined significance. AU - Kumar,Shaji, AU - Rajkumar,S Vincent, AU - Kyle,Robert A, AU - Lacy,Martha Q, AU - Dispenzieri,Angela, AU - Fonseca,Rafael, AU - Lust,John A, AU - Gertz,Morie A, AU - Greipp,Philip R, AU - Witzig,Thomas E, PY - 2005/8/20/pubmed PY - 2005/9/24/medline PY - 2005/8/20/entrez SP - 5668 EP - 74 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J Clin Oncol VL - 23 IS - 24 N2 - PURPOSE: Monoclonal gammopathy of undetermined significance (MGUS) progresses to multiple myeloma or another related plasma cell disorder (PCD) at a rate of approximately 1% per year. Identification of patients with MGUS at high risk of progression will allow development of preventive strategies. We studied the prognostic value of circulating plasma cells (PCs) in patients with MGUS to predict progression. PATIENTS AND METHODS: Patients were eligible for this retrospective analysis if they were seen at the Mayo Clinic between 1984 and 1997, were diagnosed with MGUS, and had an analysis of the peripheral blood for circulating PCs by the slide-based immunofluorescence method. Patients were observed for progression to another PCD. RESULTS: Three hundred twenty-five patients were eligible and 63 (19%) had circulating PCs. Patients with circulating PCs were twice as likely (hazard ratio, 2.1) to experience progression to another PCD (most commonly myeloma), compared with those without circulating PCs (95% CI, 1.1 to 4.3; P = .03). In patients with circulating PCs, the median progression-free survival was 138 months compared with a median not yet reached for those without circulating PCs (P = .028). The median overall survival also was shorter for those with circulating PCs. Other factors with prognostic value were high levels of M protein and non-immunoglobulin G heavy-chain type. CONCLUSION: The presence of circulating PCs, especially when combined with other known prognostic factors such as M protein concentration and immunoglobulin isotype, identify a group of individuals with MGUS at higher risk of progression to overt multiple myeloma. SN - 0732-183X UR - https://www.unboundmedicine.com/medline/citation/16110026/Prognostic_value_of_circulating_plasma_cells_in_monoclonal_gammopathy_of_undetermined_significance_ L2 - https://ascopubs.org/doi/10.1200/JCO.2005.03.159?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -