Contributions
Abstract: EP1037
Type: E-Poster Presentation
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
MGUS is the asymptomatic state of multiple myeloma and other plasma cell diseases.
Aims
To explore the disease progression rate and related factors in patients with monoclonal gammopathy of undetermined significance (MGUS).
Methods
NLP natural language processing technology and RegEx regular expression technology were used to mine clinical data from the medical hospital information system (HIS) of Peking Union Medical College Hospital and manage unstructured data. MGUS patients diagnosed from January 1, 2012 to January 31, 2021 were included, and demographic information, clinical data and follow-up results were recorded. A Cox regression model was established to evaluate the hazard ratio (HR) of various factors to the progression of multiple myeloma and other plasma cell diseases. According to the screened risk factors, a risk-stratification model was established to calculate the risk of disease progression (PD) under different risk strata.
Results
1. A total of 1288 patients with MGUS were enrolled with a median age of 65 years (21-100), majority over 50 years old (86.3%). During a median follow-up of 41 months (3-127), 74 cases developed into plasma cell diseases such as multiple myeloma, Waldenström macroglobulinemia, POEMS syndrome and amyloidosis, with an average annual progression rate of 0.54%.
2. Univariate analysis of Cox regression model showed that a history of cancer (HR 5.260, P< 0.001), Fanconi syndrome (HR 5.268, P=0.021) and abnormal ratio of serum free light chain (sFLC) (HR 1.347, P=0.013) were risk factors for the disease progression of MGUS. Multivariate analysis suggested that serum M protein ≥15g/L (HR=2.778,95%CI 1.464-5.271, p=0.00176) and IgG M protein (HR=1.847,95%CI 1.006-3.391, p=0.04778) were risk factors for PD.
3. The Cox model was used to establish a risk stratification model. If two risk factors (M protein ≥15g/L, IgG type) were included, compared with the low-risk group (M protein <15g/L, non-IgG type), the relative risk (RR) of PD in the intermediate-risk group (1 risk factor) and high-risk group (2 risk factors) were 1.51 and 4.15, respectively. If three risk factors (a history of cancer was added) were included, compared with the low-risk group (none), the relative risk (RR) of progression in low-intermediate-risk, intermediate-high-risk and high-risk groups (1,2 and 3 risk factors, respectively) were 1.43,3.80 and 11.40, respectively.
Conclusion
During past 9 years, the disease progression rate of MGUS in our center is 0.54% per year. Serum level of M protein ≥15g/L, IgG M protein, a history of cancer are the predictive factors of disease progression. The annual disease progression rate of Asian MGUS is lower than that of European and American data.
Keyword(s): MGUS
Abstract: EP1037
Type: E-Poster Presentation
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
MGUS is the asymptomatic state of multiple myeloma and other plasma cell diseases.
Aims
To explore the disease progression rate and related factors in patients with monoclonal gammopathy of undetermined significance (MGUS).
Methods
NLP natural language processing technology and RegEx regular expression technology were used to mine clinical data from the medical hospital information system (HIS) of Peking Union Medical College Hospital and manage unstructured data. MGUS patients diagnosed from January 1, 2012 to January 31, 2021 were included, and demographic information, clinical data and follow-up results were recorded. A Cox regression model was established to evaluate the hazard ratio (HR) of various factors to the progression of multiple myeloma and other plasma cell diseases. According to the screened risk factors, a risk-stratification model was established to calculate the risk of disease progression (PD) under different risk strata.
Results
1. A total of 1288 patients with MGUS were enrolled with a median age of 65 years (21-100), majority over 50 years old (86.3%). During a median follow-up of 41 months (3-127), 74 cases developed into plasma cell diseases such as multiple myeloma, Waldenström macroglobulinemia, POEMS syndrome and amyloidosis, with an average annual progression rate of 0.54%.
2. Univariate analysis of Cox regression model showed that a history of cancer (HR 5.260, P< 0.001), Fanconi syndrome (HR 5.268, P=0.021) and abnormal ratio of serum free light chain (sFLC) (HR 1.347, P=0.013) were risk factors for the disease progression of MGUS. Multivariate analysis suggested that serum M protein ≥15g/L (HR=2.778,95%CI 1.464-5.271, p=0.00176) and IgG M protein (HR=1.847,95%CI 1.006-3.391, p=0.04778) were risk factors for PD.
3. The Cox model was used to establish a risk stratification model. If two risk factors (M protein ≥15g/L, IgG type) were included, compared with the low-risk group (M protein <15g/L, non-IgG type), the relative risk (RR) of PD in the intermediate-risk group (1 risk factor) and high-risk group (2 risk factors) were 1.51 and 4.15, respectively. If three risk factors (a history of cancer was added) were included, compared with the low-risk group (none), the relative risk (RR) of progression in low-intermediate-risk, intermediate-high-risk and high-risk groups (1,2 and 3 risk factors, respectively) were 1.43,3.80 and 11.40, respectively.
Conclusion
During past 9 years, the disease progression rate of MGUS in our center is 0.54% per year. Serum level of M protein ≥15g/L, IgG M protein, a history of cancer are the predictive factors of disease progression. The annual disease progression rate of Asian MGUS is lower than that of European and American data.
Keyword(s): MGUS