ASH 2021 | Identifying MGUS-like phenotype in multiple myeloma and light-chain amyloidosis

An MGUS-like phenotype in patients with multiple myeloma and light-chain amyloidosis (AL) has been hypothesized. Bruno Paiva, PhD, University of Navarra, Pamplona, Spain, talks on a study aiming to develop an algorithm for automated identification of patients with MGUS-like phenotype. The frequency of bone marrow plasma cells and the percentages of normal and clonal plasma cells within the bone marrow plasma cell compartment were used to classify patients as MGUS-, intermediate- or myeloma-like. In the training smoldering myeloma (SMM) series, classification into these groups resulted in significantly different rates of disease progression, with those identified as MGUS-like having virtually no risk of progression at 5 years. Similarly, in the myeloma training series, individuals classified as MGUS-like has significantly longer progression-free (PFS) and overall survival, which retained independent prognostic value in a multivariate model. Finally, classification of patients with AL also resulted in significantly different PFS. Given the distinct behavior of an MGUS-like phenotype, identification could be beneficial during routine diagnosis in SMM, myeloma and AL. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.