In:
British Journal of Haematology, Wiley, Vol. 187, No. 4 ( 2019-11), p. 441-446
Abstract:
IgM monoclonal gammopathies of undetermined significance (IgM MGUS ) are associated with a risk of progression to Waldenström macroglobulinaemia ( WM ) or other lymphoproliferative disorders ( LPD ) of 1–2% per year. We analysed 176 consecutive patients with IgM MGUS to evaluate risk factors for progression. With a median follow‐up of 83 months (1214 person‐years), 15 patients (8·5%) progressed to WM ( n = 14) or marginal zone lymphoma ( n = 1). The rate of progression was 1·32% per year (95% confidence interval [ CI ] 0·80–2·20). The serum monoclonal protein concentration and the MYD 88 mutation were independent risk factors for progression (Hazard ratio [ HR ] 23·3, 95% CI 2·0–273·3, P = 0·012 and HR 24·4, 95% CI 2·2–275·3, P = 0·010, respectively). The cumulative incidence of progression, while considering death as a competing event, was 11·6% at 5 years and 38·0% at 10 years in MYD 88 ‐mutated patients with a serum monoclonal protein of 10 g/l or higher, as compared with 0% at 5 years and 1·1% at 10 years for patients with none or one risk factor. This risk‐stratification model is able to identify a subset of patients with IgM MGUS at high risk of progression to WM or LPD who deserve a lifelong follow‐up.
Type of Medium:
Online Resource
ISSN:
0007-1048
,
1365-2141
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
1475751-5
