title: Modeling progression risk for smoldering multiple myeloma: results from a prospective clinical study.
abstract: The risk of progression to multiple myeloma (MM) from the precursor condition smoldering MM (SMM) varies considerably among individual patients. Reliable markers for progression to MM are vital to advance the understanding of myeloma precursor disease and for the development of intervention trials designed to delay/prevent MM. The Mayo Clinic and Spanish PETHEMA have proposed models to stratify patient risk based on clinical parameters. The aim of our study was to define the degree of concordance between these two models by comparing the distribution of patients with SMM classified as low, medium and high risk for progression. A total of 77 patients with SMM were enrolled in our prospective natural history study. Per study protocol, each patient was assigned risk scores based on both the Mayo and the Spanish models. The Mayo Clinic model identified 38, 35 and four patients as low, medium and high risk, respectively. The Spanish PETHEMA model classified 17, 22 and 38 patients as low, medium and high risk, respectively. There was significant discordance in overall patient risk classification (28.6% concordance) and in classifying patients as low versus high (p < 0.0001), low versus non-low (p = 0.0007) and high versus non-high (p < 0.0001) risk. There is a need for prospectively validated models to characterize individual patient risk of transformation to MM.
authors: Multiple Myeloma Section, National Cancer Institute, National Institutes of Health , Bethesda, MD , USA.
authors: Benjamin M
authors: BM
authors: Cherry
authors: Neha
authors: N
authors: Korde
authors: Mary
authors: M
authors: Kwok
authors: Elisabet E
authors: EE
authors: Manasanch
authors: Manisha
authors: M
authors: Bhutani
authors: Marcia
authors: M
authors: Mulquin
authors: Diamond
authors: D
authors: Zuchlinski
authors: Mary Ann
authors: MA
authors: Yancey
authors: Irina
authors: I
authors: Maric
authors: Katherine R
authors: KR
authors: Calvo
authors: Raul
authors: R
authors: Braylan
authors: Maryalice
authors: M
authors: Stetler-Stevenson
authors: Constance
authors: C
authors: Yuan
authors: Prashant
authors: P
authors: Tembhare
authors: Adriana
authors: A
authors: Zingone
authors: Rene
authors: R
authors: Costello
authors: Mark J
authors: MJ
authors: Roschewski
authors: Ola
authors: O
authors: Landgren
mesh_terms: D002471:Cell Transformation, Neoplastic; D018450:Disease Progression; D006801:Humans; D008954:Models, Biological; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000209:etiology*; D009101:Multiple Myeloma / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D013997:Time Factors