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Monoclonal gammopathy of renal significance (MGRS): Real‐world data on outcomes and prognostic factors
Author(s) -
Gozzetti Alessandro,
Guarnieri Andrea,
Zamagni Elena,
Zakharova Elena,
Coriu Daniel,
Bittrich Max,
Pika Tomáš,
Tovar Natalia,
Schutz Natalia,
Ciofini Sara,
Peña Camila,
Rocchi Serena,
Rassner Michael,
Avivi Irit,
WaszczukGajda Anna,
Chhabra Saurabh,
UsnarskaZubkiewicz Lidia,
GonzálezCalle Verónica,
Mateos MariaVictoria,
Bocchia Monica,
Bigi Flavia,
Füllgraf Hannah,
BhasinChhabra Bhavna,
Gentile Massimo,
Davila Julio,
Vesole David H.,
Cavo Michele,
Thapa Bicky,
Crusoe Edvan,
Einsele Hermann,
Legiec Wojciech,
Charliński Grzegorz,
Jurczyszyn Artur
Publication year - 2022
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.26566
Subject(s) - medicine , retrospective cohort study
Monoclonal gammopathy of renal significance (MGRS) is a recognized clinical entity. Literature regarding treatment and its outcomes in MGRS is sparse due to the rarity and misdiagnosis of MGRS. We retrospectively analyzed 280 adults with an MGRS diagnosis from 2003 to 2020 across 19 clinical centers from 12 countries. All cases required renal biopsy for the pathological diagnosis of MGRS. Amyloidosis‐related to MGRS (MGRS‐A) was present in 180 patients; nonamyloidosis MGRS (MGRS‐NA), including a broad spectrum of renal pathologies, was diagnosed in 100 patients. The median overall survival in the studied cohort was 121.0 months (95% CI: 105.0–121.0). Patients with MGRS‐A had a shorter overall survival than patients with MGRS‐NA (HR = 0.41, 95%CI: 0.25–0.69; p = 0.0007). Both hematologic and renal responses were associated with longer survival. Achievement of ≥VGPR was generally predictive of a renal response (OR = 8.03 95%CI: 4.04–115.96; p < 0.0001), one‐fourth of patients with ≥VGPR were renal nonresponders. In MGRS‐A, factors associated with poor prognosis included elevated levels of creatinine, beta‐2‐microglobulin, and hemodialysis at diagnosis. In MGRS‐NA, only age >65 years was associated with increased risk of death. Treatments provided similar hematologic response rates in both types of MGRS. Autologous stem cell transplantation led to better response than other treatments. This multicenter and international effort is currently the largest report on MGRS.