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

doi:10.1038/bjc.2017.229

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

Department for Health

University of Birmingham
Institute of Cancer Research
The Leeds Teaching Hospitals NHS Trust
University of Leeds
University of Arkansas for Medical Sciences
Newcastle University

Research output: Contribution to journal › Article › peer-review

3 Citations (SciVal)

198 Downloads (Pure)

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 language	English
Pages (from-to)	835-839
Journal	British Journal of Cancer
Early online date	20 Jul 2017
DOIs	https://doi.org/10.1038/bjc.2017.229
Publication status	Published - 17 Sept 2017

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This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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Journal Article

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10.1038/bjc.2017.229Licence: CC BY-NC-SA

Accepted_BJC_Short_Manuscript_07.04.17
The final publication is available at Nature.com via https://doi.org/10.1038/bjc.2017.229
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Cite this

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title = "Active multiple myeloma suppresses and typically eliminates coexisting MGUS",

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.",

keywords = "Journal Article",

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

year = "2017",

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doi = "10.1038/bjc.2017.229",

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T1 - Active multiple myeloma suppresses and typically eliminates coexisting MGUS

AU - Campbell, John P

AU - Heaney, Jennifer L J

AU - Pandya, Sankalp

AU - Afzal, Zaheer

AU - Kaiser, Martin F

AU - Owen, Roger G

AU - Child, J Anthony

AU - Gregory, Walter M

AU - Morgan, Gareth J

AU - Jackson, Graham H

AU - Bunce, Chris M

AU - Drayson, Mark T

PY - 2017/9/17

Y1 - 2017/9/17

N2 - 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.

AB - 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.

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JO - British Journal of Cancer

JF - British Journal of Cancer

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Active multiple myeloma suppresses and typically eliminates coexisting MGUS

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