Clinical, genomic, and imaging predictors of myeloma progression from asymptomatic monoclonal gammopathies (SWOG S0120)

摘要: All cases of clinical myeloma (CMM) are preceded by an asymptomatic monoclonal gammopathy (AMG), classified as either undetermined significance (MGUS) or multiple (AMM). We analyzed data from AMG patients (n = 331) enrolled in a prospective, observational trial (S0120). Baseline variables, gene expression profiles (GEP) purified tumor cells, and findings magnetic resonance imaging (MRI) were correlated with the risk progression to CMM requiring therapy. GEP cells revealed that all molecular subtypes also represented phase. An increased score (>-0.26) (based on 70-gene signature, GEP70) was independent predictor CMM. Combination elevated serum free light chain, M-spike, GEP70 identified subset high (67% at 2 years) Importantly, absence these factors AMM predicted low similar MGUS. Detection (>1) focal lesions MRI conferred progression. These demonstrate signatures associated high-risk impact disease support inclusion genomic analysis management AMGs. This registered www.clinicaltrials.gov # NCT00900263.