Discover the groundbreaking development of a predictive model for bone marrow sampling in individuals with Monoclonal Gammopathy of Undetermined Significance, a significant stride in hematology research.
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Development of a Multivariable Model to Predict the Need for Bone Marrow Sampling in Persons With Monoclonal Gammopathy of Undetermined Significance : A Cohort Study Nested in a Clinical Trial.
Eythorsson et al., Ann Intern Med 2024
<!– DOI: 10.7326/M23-2540 //–>
https://doi.org/10.7326/M23-2540
A new multivariable prediction model has been developed to assess the likelihood that individuals with presumed Monoclonal gammopathy of undetermined significance (MGUS) have a bone marrow plasma cell (BMPC) percentage of 10% or greater, indicating smoldering multiple myeloma (SMM) or worse. This model, derived from the iStopMM study involving 1043 Icelandic adults with MGUS, utilizes predictors such as MGUS isotype, monoclonal protein concentration, free light-chain ratio, and total immunoglobulin concentrations. It demonstrated a c-statistic of 0.85, indicating high accuracy, with excellent calibration. When set against a 10% predicted risk threshold for SMM or worse, the model showed 86% sensitivity and 67% specificity, outperforming the Mayo Clinic risk stratification model in terms of decision-making for bone marrow sampling referral.
Importance: This model offers a more precise tool for determining the necessity of bone marrow sampling in MGUS patients, potentially reducing unnecessary referrals and procedures.
Contribution: It contributes to the field by providing a superior alternative to existing models, with implications for improving patient management and resource allocation in the diagnosis of multiple myeloma precursors.
Funding: International Myeloma Foundation and the European Research Council.