TY - JOUR
T1 - Impact of prior diagnosis of monoclonal gammopathy on outcomes in newly diagnosed multiple myeloma
AU - Goyal, Gaurav
AU - Rajkumar, S. Vincent
AU - Lacy, Martha Q.
AU - Gertz, Morie A.
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 I.
AU - Kourelis, Taxiarchis V.
AU - Warsame, Rahma
AU - Kyle, Robert A.
AU - Kumar, Shaji K.
N1 - Funding Information:
Acknowledgements This publication was made possible by CTSA Grant Number UL1 TR002377 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.
Funding Information:
Conflict of interest MAG reports personal fees from Ionis/Akcea, Alnylam, Prothena, Celgene, Janssen, grants and personal fees from Spectrum, personal fees from Annexon, Appellis, Amgen, Medscape, Physicians Education Resource, personal fees for Data Safety Monitoring board from Abbvie, personal fees from Research to Practice, speaker fees from Teva, Speaker fees from Johnson and Johnson; Speaker fees from Medscape, Speaker fees DAVA oncology; Advisory Board for Pharmacyclics Advisory Board for Proclara outside the submitted work; Royalties from Springer Publishing Grant Funding Amyloidosis Foundation; grant from International Waldenstrom FoundationNCI SPORE MM SPORE 5P50 CA186781-04. SKK received consultancy from Celgene, Millennium, Onyx, Janssen, and BMS and research funding from Celgene, Millennium, Novartis, Onyx, AbbVie, Janssen, and BMS. MQL received research funding from Celgene. DD received research funding from Karyopharm Therapeutics, Amgen, and Millennium Pharmaceuticals. PK received research funding from Takeda, Sanofi, Janssen, Glaxo Smith Kline and Amgen. AD received research funding from Jannsen, Takeda, Celgene, Pfizer, Alnylam, Prothena, and GSK, and serves on the advisory board of Takeda and Intellia. NL serves on the advisory board of Takeda and Prothena. The remaining authors declare that they have no conflict of interest.
PY - 2019/5/1
Y1 - 2019/5/1
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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U2 - 10.1038/s41375-019-0419-7
DO - 10.1038/s41375-019-0419-7
M3 - Article
C2 - 30787429
AN - SCOPUS:85061938417
VL - 33
SP - 1273
EP - 1277
JO - Leukemia
JF - Leukemia
SN - 0887-6924
IS - 5
ER -