Active multiple myeloma suppresses and typically eliminates coexisting MGUS

John P Campbell, Jennifer L J Heaney, Sankalp Pandya, Zaheer Afzal, Martin F Kaiser, Roger G Owen, J Anthony Child, Walter M Gregory, Gareth J Morgan, Graham H Jackson, Chris M Bunce, Mark T Drayson

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Abstract

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.British Journal of Cancer advance online publication, 20 July 2017; doi:10.1038/bjc.2017.229 www.bjcancer.com.

Original languageEnglish
Pages (from-to)835-839
JournalBritish Journal of Cancer
Early online date20 Jul 2017
DOIs
Publication statusPublished - 17 Sep 2017

Keywords

  • Journal Article

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    Campbell, J. P., Heaney, J. L. J., Pandya, S., Afzal, Z., Kaiser, M. F., Owen, R. G., Child, J. A., Gregory, W. M., Morgan, G. J., Jackson, G. H., Bunce, C. M., & Drayson, M. T. (2017). Active multiple myeloma suppresses and typically eliminates coexisting MGUS. British Journal of Cancer, 835-839. https://doi.org/10.1038/bjc.2017.229