IMPACT OF IMMUNOPARESIS AND ALTERED SERUM FREE LIGHT CHAIN RATIO ON THE PROGRESSION OF MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE (MGUS) IN A DISTRICT GENERAL HOSPITAL IN UNITED KINGDOM.
(Abstract release date: 05/19/16)
EHA Library. Badugama B. 06/09/16; 132840; E1291
Disclosure(s): I have nothing to disclose.
Dr. Buddhika Badugama
Contributions
Contributions
Abstract
Abstract: E1291
Type: Eposter Presentation
Background
Monoclonal gammopathy of undetermined significance (MGUS) occurs in 3% of people > 50 y and up to 10% in those > 70 years.The risk of progression is heterogenous.The numbers are expanding and the existing risk stratification models needs to be dynamically improved to ensure the clinical monitoring to be more cost effective.The impact of altered serum free light chain ratio (ASFLCR) and immunoparesis (IP) as tools on MGUS progression been analyzed in the current study, in addition to the already known prognostic factors: type of M protein and the amount of monoclonal component.
Aims
In general, we aimed to identify the impact of immunoparesis and skewed SFLCR as prognostic factors for progression of MGUS to multiple myeloma in a district general hospital in UK.The specific objectives were to determine the socio-demographic characteristics of study population;to identify proportion of de novo myeloma at presentation and MGUS progressing to myeloma; to determine the impact of immunoparesis at presentation on progression of MGUS;to identify any association between abnormal SFLCR and progression of MGUS.;to find any association between the type of light chains with the risk of progression.
Methods
A Retrospective cohort. All patients with MGUS and Myeloma from 2000 to 2013 included in the study population. Baseline immunoglobulin, paraprotein and light chain levels are the main parameters. Data sources are medical records of hematology out patients’ clinic department & electronic hematology data base. All patients with monoclonal proteins referred to Department of Hematology recruited.Other disorders contributing to immunodeficiency: hypogammaglobulinaemia, lymph proliferative disorders, autoimmune disorders, stage 4 CKD, nephrotic syndrome, and generalized hypoproteinaemic conditions, Patients on disease modifying drugs and immunosuppressive medications systemic steroids, chemoimmunotherapy within previous 1 year of diagnosis, Patients having paraproteins together with polyclonal increase in immunoglobulines on presentation were excluded from the study.
Results
Here, we have assessed the incidence of immunoparesis (IP) and abnormal serum free light chain ratio (ASFLCR) in a cohort of 653 patients with MGUS.They were 323 (49.2%) males and 333 (50.8%) females, with their ages ranging from 34 to 94y, having the median age of 71y. The median time from the diagnosis to the time of observation was 35 months.The paraproteins: IgG in 57.8%, IgM in 23.3% and IgA in 17.3%. About 1.2% of were light chain (LC) MGUS.Approximately, 10% of the myelomas were LC secreting.Kappa LC identified in 60% and Lambda in 37.6%.SFLCA was not available for the hospital before 2005. Even later, subjected to selection bias, as it is not an in house facility .Out of, 437 patients who had the assay 255 were having ASFLCR.Immunoparesis is seen in 254 (38.7%) and 402 (61.3%) have normal immunoglobulin levels.There is a significantly positive correlation with the incidence densities of myeloma in the group with >/= 2 immunoparesis. The relative risk is 4.662 (95% CI 1.847 – 11.772) and the (p 0.001).We have identified positive correlation of relative risk of MGUS progression to Myeloma in the presence of abnormal SFLCR.(Rate ratio 2.531)
Conclusion
It is apparent that immunoparesis and altered SFLC ratio play a pivotal role in accelerating the MGUS progression to myeloma. Our current study shows that there a statistically significant evidences that immunoparesis and serum free light chain ratio correlates positively with MGUS progression.
Session topic: E-poster
Keyword(s): Monoclonal gammopathy, Multiple myeloma, Serum free light chains
Type: Eposter Presentation
Background
Monoclonal gammopathy of undetermined significance (MGUS) occurs in 3% of people > 50 y and up to 10% in those > 70 years.The risk of progression is heterogenous.The numbers are expanding and the existing risk stratification models needs to be dynamically improved to ensure the clinical monitoring to be more cost effective.The impact of altered serum free light chain ratio (ASFLCR) and immunoparesis (IP) as tools on MGUS progression been analyzed in the current study, in addition to the already known prognostic factors: type of M protein and the amount of monoclonal component.
Aims
In general, we aimed to identify the impact of immunoparesis and skewed SFLCR as prognostic factors for progression of MGUS to multiple myeloma in a district general hospital in UK.The specific objectives were to determine the socio-demographic characteristics of study population;to identify proportion of de novo myeloma at presentation and MGUS progressing to myeloma; to determine the impact of immunoparesis at presentation on progression of MGUS;to identify any association between abnormal SFLCR and progression of MGUS.;to find any association between the type of light chains with the risk of progression.
Methods
A Retrospective cohort. All patients with MGUS and Myeloma from 2000 to 2013 included in the study population. Baseline immunoglobulin, paraprotein and light chain levels are the main parameters. Data sources are medical records of hematology out patients’ clinic department & electronic hematology data base. All patients with monoclonal proteins referred to Department of Hematology recruited.Other disorders contributing to immunodeficiency: hypogammaglobulinaemia, lymph proliferative disorders, autoimmune disorders, stage 4 CKD, nephrotic syndrome, and generalized hypoproteinaemic conditions, Patients on disease modifying drugs and immunosuppressive medications systemic steroids, chemoimmunotherapy within previous 1 year of diagnosis, Patients having paraproteins together with polyclonal increase in immunoglobulines on presentation were excluded from the study.
Results
Here, we have assessed the incidence of immunoparesis (IP) and abnormal serum free light chain ratio (ASFLCR) in a cohort of 653 patients with MGUS.They were 323 (49.2%) males and 333 (50.8%) females, with their ages ranging from 34 to 94y, having the median age of 71y. The median time from the diagnosis to the time of observation was 35 months.The paraproteins: IgG in 57.8%, IgM in 23.3% and IgA in 17.3%. About 1.2% of were light chain (LC) MGUS.Approximately, 10% of the myelomas were LC secreting.Kappa LC identified in 60% and Lambda in 37.6%.SFLCA was not available for the hospital before 2005. Even later, subjected to selection bias, as it is not an in house facility .Out of, 437 patients who had the assay 255 were having ASFLCR.Immunoparesis is seen in 254 (38.7%) and 402 (61.3%) have normal immunoglobulin levels.There is a significantly positive correlation with the incidence densities of myeloma in the group with >/= 2 immunoparesis. The relative risk is 4.662 (95% CI 1.847 – 11.772) and the (p 0.001).We have identified positive correlation of relative risk of MGUS progression to Myeloma in the presence of abnormal SFLCR.(Rate ratio 2.531)
Conclusion
It is apparent that immunoparesis and altered SFLC ratio play a pivotal role in accelerating the MGUS progression to myeloma. Our current study shows that there a statistically significant evidences that immunoparesis and serum free light chain ratio correlates positively with MGUS progression.
Session topic: E-poster
Keyword(s): Monoclonal gammopathy, Multiple myeloma, Serum free light chains
Abstract: E1291
Type: Eposter Presentation
Background
Monoclonal gammopathy of undetermined significance (MGUS) occurs in 3% of people > 50 y and up to 10% in those > 70 years.The risk of progression is heterogenous.The numbers are expanding and the existing risk stratification models needs to be dynamically improved to ensure the clinical monitoring to be more cost effective.The impact of altered serum free light chain ratio (ASFLCR) and immunoparesis (IP) as tools on MGUS progression been analyzed in the current study, in addition to the already known prognostic factors: type of M protein and the amount of monoclonal component.
Aims
In general, we aimed to identify the impact of immunoparesis and skewed SFLCR as prognostic factors for progression of MGUS to multiple myeloma in a district general hospital in UK.The specific objectives were to determine the socio-demographic characteristics of study population;to identify proportion of de novo myeloma at presentation and MGUS progressing to myeloma; to determine the impact of immunoparesis at presentation on progression of MGUS;to identify any association between abnormal SFLCR and progression of MGUS.;to find any association between the type of light chains with the risk of progression.
Methods
A Retrospective cohort. All patients with MGUS and Myeloma from 2000 to 2013 included in the study population. Baseline immunoglobulin, paraprotein and light chain levels are the main parameters. Data sources are medical records of hematology out patients’ clinic department & electronic hematology data base. All patients with monoclonal proteins referred to Department of Hematology recruited.Other disorders contributing to immunodeficiency: hypogammaglobulinaemia, lymph proliferative disorders, autoimmune disorders, stage 4 CKD, nephrotic syndrome, and generalized hypoproteinaemic conditions, Patients on disease modifying drugs and immunosuppressive medications systemic steroids, chemoimmunotherapy within previous 1 year of diagnosis, Patients having paraproteins together with polyclonal increase in immunoglobulines on presentation were excluded from the study.
Results
Here, we have assessed the incidence of immunoparesis (IP) and abnormal serum free light chain ratio (ASFLCR) in a cohort of 653 patients with MGUS.They were 323 (49.2%) males and 333 (50.8%) females, with their ages ranging from 34 to 94y, having the median age of 71y. The median time from the diagnosis to the time of observation was 35 months.The paraproteins: IgG in 57.8%, IgM in 23.3% and IgA in 17.3%. About 1.2% of were light chain (LC) MGUS.Approximately, 10% of the myelomas were LC secreting.Kappa LC identified in 60% and Lambda in 37.6%.SFLCA was not available for the hospital before 2005. Even later, subjected to selection bias, as it is not an in house facility .Out of, 437 patients who had the assay 255 were having ASFLCR.Immunoparesis is seen in 254 (38.7%) and 402 (61.3%) have normal immunoglobulin levels.There is a significantly positive correlation with the incidence densities of myeloma in the group with >/= 2 immunoparesis. The relative risk is 4.662 (95% CI 1.847 – 11.772) and the (p 0.001).We have identified positive correlation of relative risk of MGUS progression to Myeloma in the presence of abnormal SFLCR.(Rate ratio 2.531)
Conclusion
It is apparent that immunoparesis and altered SFLC ratio play a pivotal role in accelerating the MGUS progression to myeloma. Our current study shows that there a statistically significant evidences that immunoparesis and serum free light chain ratio correlates positively with MGUS progression.
Session topic: E-poster
Keyword(s): Monoclonal gammopathy, Multiple myeloma, Serum free light chains
Type: Eposter Presentation
Background
Monoclonal gammopathy of undetermined significance (MGUS) occurs in 3% of people > 50 y and up to 10% in those > 70 years.The risk of progression is heterogenous.The numbers are expanding and the existing risk stratification models needs to be dynamically improved to ensure the clinical monitoring to be more cost effective.The impact of altered serum free light chain ratio (ASFLCR) and immunoparesis (IP) as tools on MGUS progression been analyzed in the current study, in addition to the already known prognostic factors: type of M protein and the amount of monoclonal component.
Aims
In general, we aimed to identify the impact of immunoparesis and skewed SFLCR as prognostic factors for progression of MGUS to multiple myeloma in a district general hospital in UK.The specific objectives were to determine the socio-demographic characteristics of study population;to identify proportion of de novo myeloma at presentation and MGUS progressing to myeloma; to determine the impact of immunoparesis at presentation on progression of MGUS;to identify any association between abnormal SFLCR and progression of MGUS.;to find any association between the type of light chains with the risk of progression.
Methods
A Retrospective cohort. All patients with MGUS and Myeloma from 2000 to 2013 included in the study population. Baseline immunoglobulin, paraprotein and light chain levels are the main parameters. Data sources are medical records of hematology out patients’ clinic department & electronic hematology data base. All patients with monoclonal proteins referred to Department of Hematology recruited.Other disorders contributing to immunodeficiency: hypogammaglobulinaemia, lymph proliferative disorders, autoimmune disorders, stage 4 CKD, nephrotic syndrome, and generalized hypoproteinaemic conditions, Patients on disease modifying drugs and immunosuppressive medications systemic steroids, chemoimmunotherapy within previous 1 year of diagnosis, Patients having paraproteins together with polyclonal increase in immunoglobulines on presentation were excluded from the study.
Results
Here, we have assessed the incidence of immunoparesis (IP) and abnormal serum free light chain ratio (ASFLCR) in a cohort of 653 patients with MGUS.They were 323 (49.2%) males and 333 (50.8%) females, with their ages ranging from 34 to 94y, having the median age of 71y. The median time from the diagnosis to the time of observation was 35 months.The paraproteins: IgG in 57.8%, IgM in 23.3% and IgA in 17.3%. About 1.2% of were light chain (LC) MGUS.Approximately, 10% of the myelomas were LC secreting.Kappa LC identified in 60% and Lambda in 37.6%.SFLCA was not available for the hospital before 2005. Even later, subjected to selection bias, as it is not an in house facility .Out of, 437 patients who had the assay 255 were having ASFLCR.Immunoparesis is seen in 254 (38.7%) and 402 (61.3%) have normal immunoglobulin levels.There is a significantly positive correlation with the incidence densities of myeloma in the group with >/= 2 immunoparesis. The relative risk is 4.662 (95% CI 1.847 – 11.772) and the (p 0.001).We have identified positive correlation of relative risk of MGUS progression to Myeloma in the presence of abnormal SFLCR.(Rate ratio 2.531)
Conclusion
It is apparent that immunoparesis and altered SFLC ratio play a pivotal role in accelerating the MGUS progression to myeloma. Our current study shows that there a statistically significant evidences that immunoparesis and serum free light chain ratio correlates positively with MGUS progression.
Session topic: E-poster
Keyword(s): Monoclonal gammopathy, Multiple myeloma, Serum free light chains
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