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Baseline serum B‐cell maturation antigen levels predict time to disease progression for patients with smoldering multiple myeloma
Author(s) -
Bujarski Sean,
Goldwater MarissaSkye,
Regidor Bernard Sean,
Jew Scott,
Daniely David,
Swift Regina A.,
Eades Benjamin M.,
EmamySadr Marsiye,
Souther Eric,
Li Mingjie,
Wang Cathy,
Xu Ning,
Chen Haiming,
Spektor Tanya M.,
Berenson James R.
Publication year - 2021
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13666
Subject(s) - multiple myeloma , proportional hazards model , medicine , hazard ratio , cutoff , bone marrow , disease , oncology , receiver operating characteristic , gastroenterology , antigen , immunology , confidence interval , physics , quantum mechanics
Multiple myeloma (MM) patients with smoldering (S) disease are defined by a lack of CRAB/SLiM criteria but may transform into disease requiring treatment. The International Myeloma Working Group risk stratification model for SMM uses serum M‐protein, serum‐free light chain ratio, and bone marrow plasma cell percentage. We investigated whether baseline serum B‐cell maturation antigen (sBCMA) levels are predictive of disease progression among 65 patients with SMM. A receiver operating characteristic curve was used to establish a definition for high‐risk baseline sBCMA. Mantel Byar analysis was used to examine whether high‐risk sBCMA was correlated with shorter time to transformation, and a time‐dependent cox proportional hazard was used to determine whether it is independent of other risk factors. A z test for proportions was used to compare the percentage of patients that progressed among high‐risk versus low‐risk sBCMA patients. A baseline sBCMA level ≥137.5 mg/ml was found to be the optimal cutoff between high‐ and low‐risk SMM patients. Patients with high‐risk sBCMA levels had a shorter time to transformation ( P = .000332). sBCMA was also higher at the time of transformation than baseline levels ( P = .0116). sBCMA was the only variable found to be significantly predictive of time to transformation and additionally was found to be independent of other risk factors. In this study, we have shown for the first time that sBCMA levels predict transformation of SMM to active disease and that these levels increase at the time of transformation. These results are consistent with other studies showing that active MM patients undergoing therapy with higher baseline sBCMA levels are more likely to progress early and its levels increase at the time of disease progression.