University Hospital Brno, Brno, Czech Republic.
University Hospital Ostrava and Faculty of Medicine, Ostrava, Czech Republic.
Blood Cancer J. 2023 Sep 27;13(1):153. doi: 10.1038/s41408-023-00906-7.
Smoldering multiple myeloma (SMM) is an asymptomatic precursor to active multiple myeloma (MM). The aim of this study was to report clinical characteristics and outcomes of patients with SMM stratified based on their risk of progression to MM using the Mayo 20/2/20 criteria. Data were leveraged from the Czech Myeloma Group Registry of Monoclonal Gammopathies (RMG). Key outcomes included progression-free survival from SMM diagnosis to active MM diagnosis or death (PFS), progression-free survival from SMM diagnosis to progression on first line (1 L) MM treatment or death (PFS2), and overall survival (OS). Of 498 patients, 174 (34.9%) were classified as high risk and 324 (65.1%) as non-high risk. Median follow-up was approximately 65 months. During follow-up, more patients in the high-risk vs non-high-risk group received 1 L MM treatment (76.4% vs 46.6%, p < 0.001). PFS, PFS2, and OS were significantly shorter in high-risk vs non-high-risk patients (13.2 vs 56.6 months, p < 0.001; 49.9 vs 84.9 months, p < 0.001; 93.2 vs 131.1 months, p = 0.012, respectively). The results of this study add to the growing body of evidence that patients with high-risk vs non-high-risk SMM have significantly worse outcomes, including OS.
冒烟型多发性骨髓瘤（SMM）是一种无症状的多发性骨髓瘤（MM）前期表现。本研究旨在根据 Mayo 20/2/20 标准报告 SMM 患者的临床特征和结局，这些标准用于分层患者进展为 MM 的风险。数据来自捷克骨髓瘤小组单克隆丙种球蛋白血症登记处（RMG）。主要结局包括从 SMM 诊断到活跃 MM 诊断或死亡的无进展生存期（PFS）、从 SMM 诊断到一线（1L）MM 治疗进展或死亡的无进展生存期（PFS2）和总生存期（OS）。在 498 名患者中，174 名（34.9%）被归类为高危，324 名（65.1%）为非高危。中位随访时间约为 65 个月。在随访期间，高危组比非高危组更多的患者接受了 1L MM 治疗（76.4%比 46.6%，p<0.001）。高危组与非高危组相比，PFS、PFS2 和 OS 明显更短（13.2 比 56.6 个月，p<0.001；49.9 比 84.9 个月，p<0.001；93.2 比 131.1 个月，p=0.012）。这项研究的结果增加了越来越多的证据，表明高危与非高危 SMM 患者的结局明显更差，包括 OS。
