[MGUSer]

Studies on risk of progression with stable MGUS?

by MGUSer on Thu May 14, 2015 12:56 pm

Hi everyone,

I was wondering if there are studies / papers out there touching on the stability of MGUS and the risk of progression.

I have read a lot about progression factors, with the conclusion that the main factor is the size of the M-spike at diagnostis (for secreting myeloma at least), and that other factors such as very abnormal FLC ratios can also increase risk of progression. I also understand that it used to be that IgA was slightly more at risk of evolution, but that today's cytogenics tend to show that it is not necessarily IgA itself.

However, I have not found anything indicating if a stable MGUS and no or very little variation in the M-protein over time tend to indicate that risk of evolution is very low. For instance, if some­one has an M-spike of around 0.1, stable for more than 2 years, can there be assumptions that risk of pro­gression is very very low? Or does the 1-4% progression risk carry on independently?

Thanks for your input! Great site.

MGUSer

[Cheryl G]

Re: Studies on risk of progression with stable MGUS?

by Cheryl G on Thu May 14, 2015 2:09 pm

Hi MGUSer,

I'm not aware of any studies like the kind you seem to be looking for.

I do have a question for you, however. I realize that, in symptomatic myeloma, IgA is main­ly con­sidered to be more "aggressive" because it is associated with certain higher-risk chromo­som­al abnormalities. I do not think, though, that there has been any change in the think­ing about non-IgG MGUS being a risk factor for greater risk of progression in MGUS.

Dr. Kapoor of the Mayo Clinic earlier this year answered a question here in the forum about risk of progression in MGUS patients, and he said that having non-IgG MGUS is still con­sid­ered a factor affecting risk of progression:

"Light chain MGUS - risk of progression" (started Jan 15, 2015)

Is there a study or conference abstract that you know of that says that non-IgG should no longer be considered a factor affecting risk of progression in MGUS patients?

Thanks!