Vincent Rajkumar, Professor of Medicine at the Mayo Clinic in Rochester and Editor‑in‑Chief at Blood Cancer Journal, shared a post on X about a recent article he and his colleagues co-authored, adding:
“Just out in the Journal of Clinical Oncology!
A paradigm changing paper on MGUS and Smoldering Myeloma
And it’s Open Access!!
KEY FINDINGS:
1) We identify for the first time myeloma defining genomic events to differentiate biologic premalignancy (genomic MGUS) from biologic malignancy (genomic Myeloma).
2) We find that most of smoldering myeloma and almost all of high risk smoldering myeloma is biologic malignancy with genomic features indistinguishable from active myeloma
3) We show that some myeloma defining genomic events are also associated with high risk of progression resulting in a genomic model of risk stratification of Smoldering Myeloma.
4) We show that combining the genomic model (genomics) with the IMWG2020 model (clone size) provides a better risk stratification than either alone.
5) We provide the code and information where if you have access to sequencing you can run this yourself to determine whether the patient has genomic MGUS or genomic Myeloma
Although we found evidence of biologic malignancy in 40% of MGUS we studied, this doesn’t mean 40% of MGUS has biologic malignancy. Most patients with MGUS have low risk GUS and do not get a bone marrow biopsy. Most don’t get referred to tertiary centers unless the MGUS is associated with higher M protein or light chain levels. So our finding applies to MGUS at risk enough of needing a bone marrow exam and referral to a tertiary care center.
Kudos to Francesco Maura without whose brilliance and hard work this would not have been possible.
Our findings are similar to results presented by Nikhil C. Munshi group, where they found SMM patients have similar genomic changes as myeloma.”
Title: Genomics Define Malignant Transformation in Myeloma Precursor Conditions
Authors: Francesco Maura, P. Leif Bergsagel, Bachisio Ziccheddu, Shaji Kumar, Kylee Maclachlan, Andriy Derkach, Juan-Jose Garces, Ross Firestone, Esteban Braggio, Yan Asmann, Michael Durante, Benjamin T. Diamond, Marios Papadimitriou, Malin Hultcrantz, Alessio Marella, Giancarlo Castellano, Akihiro Maeda, Marta Lionetti, Antonio Matera, Stefania Pioggia, Matteo Claudio Da Vià, Claudio de Magistris, Daniel Leongamornlert, Danny DeAvila, Praneeth Reddy Sudalagunta, Rafael Renatino Canevarolo, Erin M. Siegel, Phaedra Agius, Jamie Teer, Andrew McPherson, Yusuke Yamashita, Ariosto S. Silva, Patrick Blaney, Rachid Baz, Krina K. Patel, Peter Campbell, Gareth Morgan, Rafael Fonseca, Ola Landgren, Robert Z. Orlowski, Kenneth H. Shain, Niccolo Bolli, Saad Usmani, S. Vincent Rajkumar
Read the Full Article on Journal of Clinical Oncology
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