Quantitative risk of underlying disease conditions for progression from monoclonal gammopathy to multiple myeloma: a nationwide cohort study.

BACKGROUND

This nationwide real-world data cohort study developed a risk-scoring model to predict the progression of monoclonal gammopathy of undetermined significance (MGUS) to symptomatic multiple myeloma (MM) using prior disease conditions.

MATERIALS AND METHODS

The Health Insurance Review and Assessment Service database, which covers nearly the entire Korean population, was utilized in this study. Out of 5361 MGUS patients, 345 (6.4%) were diagnosed with MM, with 253 (73.3%) of them progressing to symptomatic MM.

RESULTS

We identified female sex, chronic pulmonary disease, peptic ulcer disease, diabetes, and non-malignant hematologic disorder as significant risk factors and integrated these into the risk-scoring model. MGUS patients can be stratified into low-, intermediate-, and high-risk groups for progression to symptomatic MM using this model. The high-risk group showed a hazard ratio (HR) of 2.53 [95% confidence interval (CI) 1.70-3.75] compared with the low-risk group, and the intermediate-risk group showed an HR of 1.38 (95% CI 1.02-1.86) compared with the low-risk group.

CONCLUSION

This scoring model will help in the early detection of MGUS patients at high risk for symptomatic MM and allow for a more efficient allocation of health care resources to those patients who require intensive monitoring.