New criteria to identify risk of progression in monoclonal gammopathy of uncertain significance and smoldering multiple myeloma based on multiparameter flow cytometry analysis of bone marrow plasma cells
Open accessAbstract
Monoclonal gammopathy of uncertain significance (MGUS) and smoldering multiple myeloma (SMM) are plasma cell disorders with a risk of progression of approximately 1% and 10% per year, respectively. We have previously shown that the proportion of bone marrow (BM) aberrant plasma cells (aPCs) within the BMPC compartment (aPC/BMPC) as assessed by flow cytometry (FC) contributes to differential diagnosis between MGUS and multiple myloma (MM). The goal of the present study was to investigate this parameter as a marker for risk of progression in MGUS (n = 407) and SMM (n = 93). Patients with a marked predominance of aPCs/BMPC (≥ 95%) at diagnosis displayed a significantly higher risk of progression both in MGUS and SMM (P< .001). Multivariate analysis for progression-free survival (PFS) selected the percentage aPC/BMPC (≥ 95%) as the most important independent variable, together with DNA aneuploidy and immunoparesis, for MGUS and SMM, respectively. Using these independent variables, we have identified 3 risk categories in MGUS (PFS at 5 years of 2%, 10%, and 46%, respectively; P< .001) and SMM patients (PFS at 5 years of 4%, 46%, and 72%, respectively; P < .001). Our results show that multiparameter FC evaluation of BMPC at diagnosis is a valuable tool that could help to individualize the follow-up strategy for MGUS and SMM patients.
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These third-group patients are well captured by integrating independent disease-burden-based prognostic scores (e.g., IMWG and PETHEMA).
“Typically, these patients are well captured by integrating independent disease-burden-based prognostic scores (e.g., IMWG and PETHEMA).7,102,103”
From Evolution of Multiple Myeloma from a Genomic Perspective (2026) · cites this paper as [102]
The Results and Discussion (page unavailable) describe a prognostic score that separates MGUS and smoldering myeloma patients into three progression-risk groups. The paper does not show that integrating its score with an IMWG score captures the citing document’s “third-group patients”; it says prospective work would be needed to explore whether its flow-cytometry measure and another risk measure are independent. (LLM, conf=0.84)
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- Authors
- Pérez-Persona, E., Vidriales, M.-B., Mateo, G., García-Sanz, R., Mateos, M.-V., de Coca, A. G., Galende, J., Martín-Nuñez, G., Alonso, J. M., de las Heras, N., Hernández, J. M., Martín, A., López-Berges, C., Orfao, A., & San Miguel, J. F.
- Affiliations
- Department of Hematology, University Hospital, Salamanca;
- Department of Hematology, University Hospital, Valladolid;
- Hospital El Bierzo (ES)
- Department of Hematology, Hospital Nuestra Señora del Puerto de Plasencia, Cáceres;
- Hospital Rio Carrion (ES)
- Department of Hematology, Complejo Hospitalario, León;
- Hospital General De Segovia (ES)
- Department of Hematology, Hospital Virgen de la Concha, Zamora; and
- Centro de Investigación del Cancer, Universidad de Salamanca/Consejo Superior de Investigaciones Cientificas (CSIC), Salamanca;
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2007-10-01
- Volume
- 110
- Issue
- 7
- Pages
- 2586-2592
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- OpenAlex
- W2156381278
- Cited by
- 579
- References
- 1
- Citations by year
- 2026: 23 · 2025: 35 · 2024: 41 · 2023: 29 · 2022: 32 · 2021: 33 · 2020: 34 · 2019: 19 · 2018: 33 · 2017: 42 · 2016: 36 · 2015: 35 · 2014: 35 · 2013: 44 · 2012: 29
- FWCI
- 10.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Blood (publishedVersion)
- PubMed (publishedVersion)
- Hispana (publishedVersion, cc-by-nc-nd)
- Gredos (University of Salamanca) (submittedVersion, cc-by-nc-nd)
- DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion)
- Funders
- Instituto de Salud Carlos III
- Topics
- Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
- Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Amyloidosis: Diagnosis, Treatment, Outcomes
- Keywords
- monoclonal gammopathy of undetermined significance, smoldering multiple myeloma, progression risk, bone marrow plasma cells, multiparameter flow cytometry, DNA aneuploidy, immunoparesis, progression-free survival, risk stratification, follow-up strategy
- MeSH terms
- Adult, Aged, Aged, 80 and over, Bone Marrow Cells, Female, Flow Cytometry, Humans, Male, Middle Aged, Multiple Myeloma, Paraproteinemias, Phenotype, Plasma Cells, Risk Factors, Disease Progression
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