title: A first Czech analysis of 1887 cases with monoclonal gammopathy of undetermined significance.
abstract: BACKGROUND
  Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition with a risk of malignant conversion.
  
  
  METHODS
  With the aim to estimate the cumulative risk MGUS progression to hematologic malignancies, we analyzed a nationwide population-based cohort of 1887 MGUS patients from the Czech Registry of Monoclonal Gammopathies (RMG) between 2007 and 2013.
  
  
  RESULTS
  During the follow-up period (median 4 years; range 0.6-34.8), progression to hematologic malignancies was observed in 8.6% (162 of 1887) of patients. Factors associated with progression were as follows: M-protein concentration ≥1.5 g/dL, pathological sFLC (<0.26 or >1.65) ratio, bone marrow plasma cells (BMPCs) in cytology >5%, immunoparesis, age ≥69 years, and the level of serum hemoglobin at baseline <12.0 g/dL. Combining these factors, we propose a new risk model (CMG model). The risk of progression at 10 years was 1.6%, 16.9%, 22.9%, 39.4%, and 52.3%, respectively, if 0 (reference group), one, two, three, or four to five risk factors are present (P<.001) with HR 63 times higher compared to the reference MGUS group.
  
  
  CONCLUSIONS
  The new CMG model was established with an advantage for better identification of MGUS patients at low risk.
authors.affiliation: Department of Internal Medicine, Hematology and Oncology, University Hospital, Brno, Czech Republic.
authors.forename: Viera
authors.identifier: http://orcid.org/0000-0003-4074-8497
authors.initials: V
authors.lastname: Sandecká
authors.affiliation: Department of Clinical Hematology, University Hospital, Ostrava, Czech Republic.|Babak Myeloma Group, Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.|Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Hájek
authors.affiliation: Department of Internal Medicine, Hematology and Oncology, University Hospital, Brno, Czech Republic.
authors.forename: Luděk
authors.initials: L
authors.lastname: Pour
authors.affiliation: Department of Internal Medicine, University Hospital, Praha, Czech Republic.
authors.forename: Ivan
authors.initials: I
authors.lastname: Špička
authors.affiliation: Department of Hemato-Oncology, University Hospital, Olomouc, Czech Republic.
authors.forename: Vlastimil
authors.initials: V
authors.lastname: Ščudla
authors.affiliation: Department of Clinical Hematology, University Hospital Kralovske Vinohrady, Praha, Czech Republic.
authors.forename: Evžen
authors.initials: E
authors.lastname: Gregora
authors.affiliation: Department of Medicine - Hematology, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Jakub
authors.initials: J
authors.lastname: Radocha
authors.affiliation: Department of Clinical Hematology, Hospital Liberec, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Walterová
authors.affiliation: Department of Hematology and Transfusion Medicine, Hospital Pelhřimov, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Kessler
authors.affiliation: Department of Clinical Hematology, University Hospital, Ostrava, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Zahradová
authors.affiliation: Department of Hematology and Transfusion, Hospital Opava, Czech Republic.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Adamová
authors.affiliation: Department of Clinical Hematology, Thomayer Hospital, Praha, Czech Republic.
authors.forename: Kamila
authors.initials: K
authors.lastname: Valentova
authors.affiliation: Department of Clinical Hematology, Hospital České Budejovice, Czech Republic.
authors.forename: Ivan
authors.initials: I
authors.lastname: Vonke
authors.affiliation: Department of Hematology and Transfusion, Hospital Mlada Boleslav, Czech Republic.
authors.forename: Jarmila
authors.initials: J
authors.lastname: Obernauerová
authors.affiliation: Department of Clinical Hematology, Hospital Havířov, Czech Republic.
authors.forename: David
authors.initials: D
authors.lastname: Starostka
authors.affiliation: Department of Clinical Hematology, Hospital Nový Jičín, Czech Republic.
authors.forename: Marek
authors.initials: M
authors.lastname: Wróbel
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Lucie
authors.initials: L
authors.lastname: Brožová
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Jarkovský
authors.affiliation: Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic.|Laboratory of Molecular Cytogenetics, Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic.
authors.forename: Aneta
authors.initials: A
authors.lastname: Mikulášová
authors.affiliation: Department of Clinical Hematology, University Hospital Brno, Brno, Czech Republic.
authors.forename: Lucie
authors.initials: L
authors.lastname: Říhová
authors.affiliation: Babak Myeloma Group, Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.|Department of Clinical Hematology, University Hospital Brno, Brno, Czech Republic.
authors.forename: Sabina
authors.identifier: http://orcid.org/0000-0002-7194-6771
authors.initials: S
authors.lastname: Ševčíková
authors.affiliation: Department of Internal Medicine, University Hospital, Praha, Czech Republic.
authors.forename: Ján
authors.initials: J
authors.lastname: Straub
authors.affiliation: Department of Hemato-Oncology, University Hospital, Olomouc, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Minařík
authors.affiliation: Department of Internal Medicine, Hematology and Oncology, University Hospital, Brno, Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Adam
authors.affiliation: Department of Internal Medicine, Hematology and Oncology, University Hospital, Brno, Czech Republic.
authors.forename: Marta
authors.initials: M
authors.lastname: Krejčí
authors.affiliation: Department of Internal Medicine, Hematology and Oncology, University Hospital, Brno, Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Král
authors.affiliation: Department of Medicine - Hematology, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Vladimír
authors.initials: V
authors.lastname: Maisnar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001853:Bone Marrow / Q000473:pathology; D002471:Cell Transformation, Neoplastic; D018153:Czech Republic / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D009194:Myeloma Proteins / Q000378:metabolism; D010950:Plasma Cells / Q000378:metabolism / Q000473:pathology; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D009194:Myeloma Proteins; C085016:multiple myeloma M-proteins
keywords: monoclonal gammopathy; multiple myeloma; progression; risk factors