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Multiple myeloma, gammopathies

The pattern of the M-protein in smoldering myeloma over the time: an evolving risk factor

Leukemia volume 32, pages 2082–2094 (2018)Cite this article

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We appreciated the comments by Lakshman et al. on our article and we have read with interest the comparison of our results in patients with evolving smoldering multiple myeloma (SMM) in Barcelona [1] with their experience at the Mayo Clinic [2]. They have risen a number of questions that allow us to further clarify and expand on specific points on our manuscript.

As described in the methods section, criteria for the diagnosis of “evolving” varied with the initial M-protein concentration. Of the 47 patients with evolving pattern, the M-spike was <30 g/L in 21 (44.7%) and ≥30 g/L in 26 (55.3%). The median time to progression to symptomatic multiple myeloma (MM) of the patients belonging to these two subgroups was short, 12.2 and 6 months, respectively. We have also analyzed the absolute increase of the M component for all evolving patients from the diagnosis of the SMM at the time of finding the evolving type; this value did not allow us further predictive capacity of the evolving subtype. In the first group of patients with <30 gL, 13 had an increase of <5 g/L; the percentage of progression to MM was quite similar between both groups.

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References

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Authors and Affiliations

  1. Departments of Hematology, Amyloidosis and Myeloma Unit. Hospital Clínic, IDIBAPS., University of Barcelona., Villarroel 170, 08036, Barcelona, Spain

    Carlos Fernández de Larrea, Ignacio Isola, Ma Teresa Cibeira, Joan Bladé & Laura Rosiñol

  2. Departments of Hemotherapy and Hemostasis, Amyloidosis and Myeloma Unit. Hospital Clínic, IDIBAPS., University of Barcelona., Villarroel 170, 08036, Barcelona, Spain

    Arturo Pereira

Authors
  1. Carlos Fernández de Larrea
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  2. Ignacio Isola
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  3. Arturo Pereira
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  4. Ma Teresa Cibeira
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  5. Joan Bladé
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  6. Laura Rosiñol
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Correspondence to Joan Bladé.

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Fernández de Larrea, C., Isola, I., Pereira, A. et al. The pattern of the M-protein in smoldering myeloma over the time: an evolving risk factor. Leukemia 32, 2082–2094 (2018). https://doi.org/10.1038/s41375-018-0156-3

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