First seen on Cancer Network

In a recent study published in JAMA Oncology, patients with multiple myeloma showed better overall survival if they knew they had MGUS before their myeloma became active. But patients with MGUS who progressed to active myeloma also had a higher rate of comorbidities, compared to those who had no idea they had MGUS.

According to an article published in Cancer Network, the Iceland study investigator noted:

“Our results reflect the importance of lifelong follow-up for individuals diagnosed as having MGUS, independent of risk score, and highlight the need for better risk models based on the biology of the disease,” wrote Elin Edda Sigurdardottir, BS, of the University of Iceland, and colleagues. “Patients should receive balanced information stressing not only the overall very low risk of progression to malignant neoplasm but also the symptoms that could signal such development and the need to consult their physician.”

The study included patients 14,798 Swedish patients patients diagnosed with multiple myeloma in Sweden between 1976 and 2005, with follow-up until 2007. Of these patients, 2.7% were identified as having prior knowledge of having MGUS.

Those patients with multiple myeloma and prior knowledge of MGUS had a significantly improved overall survival compared with patients with no prior knowledge (HR = 0.86; 95% CI, 0.77-0.96). The median overall survival for those with prior MGUS knowledge was 2.8 years compared with 2.1 years for those without prior knowledge. In addition, data from an analysis looking at cause-specific survival showed that patients with prior MGUS knowledge had a lower risk of dying compared to those patients without prior MGUS knowledge.

The researchers also found that among patients with prior MGUS knowledge an M-protein concentration of less than 5 g/dL was associated with a poorer overall survival (HR = 1.86; 95% CI, 1.13-3.04).

The researchers noted the other factors faced by the MGUS patients in the study:

“In models focusing on the impact of comorbidities at diagnosis of multiple myeloma in relation to prior knowledge of MGUS, we found autoimmune diseases, infections, nonhematological malignant diseases, ischemic heart disease, heart failure, cerebrovascular diseases, and renal diseases to be significantly more common in multiple myeloma patients with prior knowledge of MGUS,” the researchers wrote.

Drs. Robert Kyle, MD and Dr. Vincent Rajkumar, MD of the Mayo Clinic commented in an editorial on the findings:

“It cannot be determined whether multiple myeloma patients with a known MGUS in the Icelandic study were followed more closely than those in whom a MGUS was not recognized, and hence it is difficult to attribute a causal relationship between follow-up and better prognosis.”