title: Smoldering multiple myeloma risk factors for progression: a Danish population-based cohort study.
abstract: Several risk scores for disease progression in patients with smoldering multiple myeloma (SMM) have been proposed; however, all have been developed using single-center registries. To examine risk factors for time to progression (TTP) to multiple myeloma (MM) for SMM, we analyzed a nationwide population-based cohort of 321 patients with newly diagnosed SMM registered within the Danish Multiple Myeloma Registry between 2005 and 2014. Significant univariable risk factors for TTP were selected for multivariable Cox regression analyses. We found that both an M-protein ≥30 g/L and immunoparesis significantly influenced TTP (HR 2.7, 95%CI (1.5;4.7), P = 0.001, and HR 3.3, 95%CI (1.4;7.8), P = 0.002, respectively). High free light chain (FLC) ratio did not significantly influence TTP in our cohort. Therefore, our data do not support recent IMWG proposal of identifying patients with FLC ratio above 100 as having ultra high-risk of transformation to MM. Using only immunoparesis and M-protein ≥30 g/L, we created a scoring system to identify low-, intermediate-, and high-risk SMM. This first population-based study of patients with SMM confirms that an M-protein ≥30 g/L and immunoparesis remain important risk factors for progression to MM.
authors.affiliation: Department of Hematology, Rigshospitalet, Copenhagen, Denmark.|Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Sørrig
authors.affiliation: Hematological Research Laboratory, Herlev Hospital, Herlev, Denmark.
authors.forename: Tobias W
authors.initials: TW
authors.lastname: Klausen
authors.affiliation: Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Salomo
authors.affiliation: Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Annette J
authors.initials: AJ
authors.lastname: Vangsted
authors.affiliation: Department of Hematology, Odense University Hospital, Odense, Denmark.
authors.forename: Brian
authors.initials: B
authors.lastname: Østergaard
authors.affiliation: Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Gregersen
authors.affiliation: Department of Hematology, Roskilde Hospital, Roskilde, Denmark.
authors.forename: Ulf Christian
authors.initials: UC
authors.lastname: Frølund
authors.affiliation: Department of Hematology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Niels F
authors.initials: NF
authors.lastname: Andersen
authors.affiliation: Department of Hematology, Herlev Hospital, Herlev, Denmark.
authors.forename: Carsten
authors.initials: C
authors.lastname: Helleberg
authors.affiliation: Department of Internal Medicine, Hematological Section, Vejle Hospital, Vejle, Denmark.
authors.forename: Kristian T
authors.initials: KT
authors.lastname: Andersen
authors.affiliation: Department of Internal Medicine, Hematological section, Holstebro Hospital, Holstebro, Denmark.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Pedersen
authors.affiliation: Department of Hematology, Esbjerg Hospital, Esbjerg, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Pedersen
authors.affiliation: Department of Hematology, Odense University Hospital, Odense, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Abildgaard
authors.affiliation: Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Gimsing
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor; D003718:Denmark; D018450:Disease Progression; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D009194:Myeloma Proteins; D010265:Paraproteinemias / Q000453:epidemiology* / Q000473:pathology*; D011159:Population Surveillance; D011379:Prognosis; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; D007147:Immunoglobulin Light Chains; D009194:Myeloma Proteins; C085016:multiple myeloma M-proteins
keywords: Immunoparesis; Risk Factors; Smoldering Multiple Myeloma