Active multiple myeloma suppresses and typically eliminates coexisting MGUS
John P Campbell1,2, Jennifer L J Heaney1, Sankalp Pandya1
1Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK.
British Journal of Cancer
|July 21, 2017
Summary
Multiple myeloma typically eliminates or suppresses precursor monoclonal gammopathy of undetermined significance (MGUS) clones. This study found biclonal gammopathy myeloma (BGMy) in less than 1% of patients, indicating MGUS eradication.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Monoclonal gammopathy of undetermined significance (MGUS) precedes multiple myeloma.
- A subset of MGUS patients (>5%) develop a second MGUS clone (biclonal gammopathy of undetermined significance; BGUS).
- Biclonal gammopathy myeloma (BGMy) is less frequent at diagnosis, suggesting myeloma eradicates coexisting MGUS.
Purpose of the Study:
- To determine the frequency of BGMy at myeloma diagnosis.
- To investigate the interaction between MGUS and myeloma plasma cell clones.
Main Methods:
- Analysis of 6399 newly diagnosed myeloma patients from UK clinical trials.
- Assessment of BGMy frequency compared to expected prevalence.
Main Results:
- BGMy was identified in only 0.91% (58/6399) of newly diagnosed myeloma patients.
- The MGUS clone was significantly suppressed in size in BGMy cases.
- The MGUS clone did not inhibit the myeloma plasma cell clone.
Conclusions:
- Multiple myeloma typically eliminates coexisting MGUS clones.
- When not eliminated, the MGUS clone is substantially reduced in size by the myeloma clone.
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