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Active multiple myeloma suppresses and typically eliminates coexisting MGUS

Lookup NU author(s): Professor Graham Jackson

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Abstract

© 2017 Cancer Research UK. All rights reserved. Background: Myeloma is consistently preceded by premalignant monoclonal gammopathy of undetermined significance (MGUS). In >5% of MGUS patients there is a second MGUS clone (biclonal gammopathy of undetermined significance; BGUS), yet, at myeloma diagnosis, presentation of biclonal gammopathy myeloma (BGMy) is considered less frequent, implying that myeloma eradicates coexisting MGUS.Methods: In the largest study of its kind, we assessed BGMy frequency amongst 6399 newly diagnosed myeloma patients enrolled in recent UK clinical trials.Results: Compared to expected prevalence (i.e., >5% of MGUS have BGUS), only 58 of 6399 (0.91%) newly diagnosed myeloma patients had BGMy, indicating myeloma typically eliminates coexistent MGUS. In these 58 BGMy cases, the MGUS plasma cell clone was greatly suppressed in size compared to typical levels observed in conventional MGUS; contrarily, the MGUS clone did not inhibit the myeloma plasma cell clone in BGMy.Conclusion: Myeloma eliminates the majority of competing MGUS, and when it does not, the MGUS clone is substantially reduced in size.

Publication metadata

Author(s): Campbell JP, Heaney JLJ, Pandya S, Afzal Z, Kaiser M, Owen R, Child JA, Gregory W, Morgan GJ, Jackson GH, Bunce CM, Drayson MT

Publication type: Article

Publication status: Published

Journal: British Journal of Cancer

Year: 2017

Volume: 117

Issue: 6

Pages: 835-839

Print publication date: 05/09/2017

Online publication date: 20/07/2017

Acceptance date: 22/06/2017

ISSN (print): 0007-0920

ISSN (electronic): 1532-1827

Publisher: Nature Publishing Group

URL: https://doi.org/10.1038/bjc.2017.229

DOI: 10.1038/bjc.2017.229

PubMed id: 28728165

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