Active multiple myeloma suppresses and typically eliminates coexisting MGUS.
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Date
2017-09-05ICR Author
Author
Campbell, JP
Heaney, JLJ
Pandya, S
Afzal, Z
Kaiser, M
Owen, R
Child, JA
Gregory, W
Morgan, GJ
Jackson, GH
Bunce, CM
Drayson, MT
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND: Myeloma is consistently preceded by premalignant monoclonal gammopathy of undetermined significance (MGUS). In >5% of MGUS patients there is a second MGUS clone (biclonal gammopathy of undetermined significance; BGUS), yet, at myeloma diagnosis, presentation of biclonal gammopathy myeloma (BGMy) is considered less frequent, implying that myeloma eradicates coexisting MGUS. METHODS: In the largest study of its kind, we assessed BGMy frequency amongst 6399 newly diagnosed myeloma patients enrolled in recent UK clinical trials. RESULTS: Compared to expected prevalence (i.e., >5% of MGUS have BGUS), only 58 of 6399 (0.91%) newly diagnosed myeloma patients had BGMy, indicating myeloma typically eliminates coexistent MGUS. In these 58 BGMy cases, the MGUS plasma cell clone was greatly suppressed in size compared to typical levels observed in conventional MGUS; contrarily, the MGUS clone did not inhibit the myeloma plasma cell clone in BGMy. CONCLUSION: Myeloma eliminates the majority of competing MGUS, and when it does not, the MGUS clone is substantially reduced in size.
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Subject
Humans
Multiple Myeloma
Precancerous Conditions
Disease Progression
Immunoglobulin A
Immunoglobulin G
Immunoglobulin M
Antibodies, Monoclonal
Prevalence
Analysis of Variance
Cell Size
Adult
Aged
Aged, 80 and over
Middle Aged
Monoclonal Gammopathy of Undetermined Significance
Research team
Myeloma Group
Myeloma Group
Language
eng
Date accepted
2017-06-22
Citation
British journal of cancer, 2017, 117 (6), pp. 835 - 839
Publisher
NATURE PUBLISHING GROUP