Impact of prior diagnosis of monoclonal gammopathy on outcomes in newly diagnosed multiple myeloma

Gaurav Goyal, S Vincent Rajkumar, Martha Lacy, Morie Gertz, Francis K. Buadi, Angela Dispenzieri, Yi L. Hwa, Amie L. Fonder, Miriam A. Hobbs, Suzanne R. Hayman, Steven R. Zeldenrust, John A. Lust, Stephen J Russell, Nelson Leung, Prashant Kapoor, Ronald S. Go, Wilson Gonsalves, Taxiarchis V. Kourelis, Rahma Warsame, Robert A. Kyle & 1 others Shaji K Kumar

Research output: Contribution to journalArticle

Abstract

Multiple myeloma (MM) is consistently preceded by monoclonal gammopathy of undetermined significance (MGUS), smoldering myeloma (SMM), or solitary plasmacytoma (SPC). There is a lack of data regarding impact of these pre-existing monoclonal gammopathies (MGs) on MM outcomes. Patients with prior diagnosis of MGUS, SMM, or PC from 1973 to 2015 (cases) were identified from our institution’s database and compared to those without a known MG (controls). The primary outcome of interest was overall survival (OS). Multivariate analysis was performed to ascertain factors impacting all-cause mortality. We identified 774 patients with a prior diagnosis of MGUS, SMM or SPC (cases) and a control population (1:2) matched for the year of diagnosis (n = 1548). After a median follow-up of 81 months, the cases showed a longer median OS than the controls (71 months vs. 56 months). The improved OS was limited to those with a known prior diagnosis of SMM (80 months) and SPC (95 months), compared to MGUS (60 months). Multivariable analysis revealed that MM patients with known prior MG had less overall mortality than those without, and this was limited to prior SMM/SPC group (HR 0.68, 95% CI: 0.50–0.93), as compared to the MGUS group (HR 0.83, 95% CI: 0.66–1.05).

Original languageEnglish (US)
JournalLeukemia
DOIs
StatePublished - Jan 1 2019

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Monoclonal Gammopathy of Undetermined Significance
Paraproteinemias
Multiple Myeloma
Plasmacytoma
Survival
Mortality
Multivariate Analysis
Databases
Population

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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Impact of prior diagnosis of monoclonal gammopathy on outcomes in newly diagnosed multiple myeloma. / Goyal, Gaurav; Rajkumar, S Vincent; Lacy, Martha; Gertz, Morie; Buadi, Francis K.; Dispenzieri, Angela; Hwa, Yi L.; Fonder, Amie L.; Hobbs, Miriam A.; Hayman, Suzanne R.; Zeldenrust, Steven R.; Lust, John A.; Russell, Stephen J; Leung, Nelson; Kapoor, Prashant; Go, Ronald S.; Gonsalves, Wilson; Kourelis, Taxiarchis V.; Warsame, Rahma; Kyle, Robert A.; Kumar, Shaji K.

In: Leukemia, 01.01.2019.

Research output: Contribution to journalArticle

Goyal, Gaurav ; Rajkumar, S Vincent ; Lacy, Martha ; Gertz, Morie ; Buadi, Francis K. ; Dispenzieri, Angela ; Hwa, Yi L. ; Fonder, Amie L. ; Hobbs, Miriam A. ; Hayman, Suzanne R. ; Zeldenrust, Steven R. ; Lust, John A. ; Russell, Stephen J ; Leung, Nelson ; Kapoor, Prashant ; Go, Ronald S. ; Gonsalves, Wilson ; Kourelis, Taxiarchis V. ; Warsame, Rahma ; Kyle, Robert A. ; Kumar, Shaji K. / Impact of prior diagnosis of monoclonal gammopathy on outcomes in newly diagnosed multiple myeloma. In: Leukemia. 2019.
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abstract = "Multiple myeloma (MM) is consistently preceded by monoclonal gammopathy of undetermined significance (MGUS), smoldering myeloma (SMM), or solitary plasmacytoma (SPC). There is a lack of data regarding impact of these pre-existing monoclonal gammopathies (MGs) on MM outcomes. Patients with prior diagnosis of MGUS, SMM, or PC from 1973 to 2015 (cases) were identified from our institution’s database and compared to those without a known MG (controls). The primary outcome of interest was overall survival (OS). Multivariate analysis was performed to ascertain factors impacting all-cause mortality. We identified 774 patients with a prior diagnosis of MGUS, SMM or SPC (cases) and a control population (1:2) matched for the year of diagnosis (n = 1548). After a median follow-up of 81 months, the cases showed a longer median OS than the controls (71 months vs. 56 months). The improved OS was limited to those with a known prior diagnosis of SMM (80 months) and SPC (95 months), compared to MGUS (60 months). Multivariable analysis revealed that MM patients with known prior MG had less overall mortality than those without, and this was limited to prior SMM/SPC group (HR 0.68, 95{\%} CI: 0.50–0.93), as compared to the MGUS group (HR 0.83, 95{\%} CI: 0.66–1.05).",
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AU - Goyal, Gaurav

AU - Rajkumar, S Vincent

AU - Lacy, Martha

AU - Gertz, Morie

AU - Buadi, Francis K.

AU - Dispenzieri, Angela

AU - Hwa, Yi L.

AU - Fonder, Amie L.

AU - Hobbs, Miriam A.

AU - Hayman, Suzanne R.

AU - Zeldenrust, Steven R.

AU - Lust, John A.

AU - Russell, Stephen J

AU - Leung, Nelson

AU - Kapoor, Prashant

AU - Go, Ronald S.

AU - Gonsalves, Wilson

AU - Kourelis, Taxiarchis V.

AU - Warsame, Rahma

AU - Kyle, Robert A.

AU - Kumar, Shaji K

PY - 2019/1/1

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N2 - Multiple myeloma (MM) is consistently preceded by monoclonal gammopathy of undetermined significance (MGUS), smoldering myeloma (SMM), or solitary plasmacytoma (SPC). There is a lack of data regarding impact of these pre-existing monoclonal gammopathies (MGs) on MM outcomes. Patients with prior diagnosis of MGUS, SMM, or PC from 1973 to 2015 (cases) were identified from our institution’s database and compared to those without a known MG (controls). The primary outcome of interest was overall survival (OS). Multivariate analysis was performed to ascertain factors impacting all-cause mortality. We identified 774 patients with a prior diagnosis of MGUS, SMM or SPC (cases) and a control population (1:2) matched for the year of diagnosis (n = 1548). After a median follow-up of 81 months, the cases showed a longer median OS than the controls (71 months vs. 56 months). The improved OS was limited to those with a known prior diagnosis of SMM (80 months) and SPC (95 months), compared to MGUS (60 months). Multivariable analysis revealed that MM patients with known prior MG had less overall mortality than those without, and this was limited to prior SMM/SPC group (HR 0.68, 95% CI: 0.50–0.93), as compared to the MGUS group (HR 0.83, 95% CI: 0.66–1.05).

AB - Multiple myeloma (MM) is consistently preceded by monoclonal gammopathy of undetermined significance (MGUS), smoldering myeloma (SMM), or solitary plasmacytoma (SPC). There is a lack of data regarding impact of these pre-existing monoclonal gammopathies (MGs) on MM outcomes. Patients with prior diagnosis of MGUS, SMM, or PC from 1973 to 2015 (cases) were identified from our institution’s database and compared to those without a known MG (controls). The primary outcome of interest was overall survival (OS). Multivariate analysis was performed to ascertain factors impacting all-cause mortality. We identified 774 patients with a prior diagnosis of MGUS, SMM or SPC (cases) and a control population (1:2) matched for the year of diagnosis (n = 1548). After a median follow-up of 81 months, the cases showed a longer median OS than the controls (71 months vs. 56 months). The improved OS was limited to those with a known prior diagnosis of SMM (80 months) and SPC (95 months), compared to MGUS (60 months). Multivariable analysis revealed that MM patients with known prior MG had less overall mortality than those without, and this was limited to prior SMM/SPC group (HR 0.68, 95% CI: 0.50–0.93), as compared to the MGUS group (HR 0.83, 95% CI: 0.66–1.05).

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