Clinical and Genomic Predictors of Progression to Myeloma in Patients With Asymptomatic Monoclonal Gammopathies

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    M.D. Anderson Cancer Center
Updated on 26 January 2022
multiple myeloma
monoclonal antibodies
monoclonal protein
bone marrow plasma cells


The goal of this study is to find markers that may help to predict why some patients who have monoclonal gammopathy of unknown significance (MGUS) or smoldering multiple myeloma (SMM) that have no signs or symptoms of disease (asymptomatic) develop multiple myeloma, while others do not. Studying markers such as age, level of proteins in blood, percent of abnormal blood cells in the bone marrow, genes in the abnormal blood cells, and bone abnormalities may help researchers to validate clinical and genomic predictors for future use in clinical practice.



I. To determine the rate of progression to multiple myeloma after 3 years of follow up.


I. To describe baseline patient characteristics and clinical variables. II. To identify molecular and genetic correlates that may predict for progression to multiple myeloma (MM).


Patients undergo collection of blood samples every 6 months for 3 years. Patients may also undergo a biopsy, x-rays, positron emission tomography (PET)/computed tomography (CT) scans, and/or magnetic resonance imaging (MRI) scans to check the status of disease at the discretion of the treating physician.

After completion of 3 years on study, patients are followed up every 6-12 months thereafter.

Condition Monoclonal Gammopathy of Undetermined Significance, Smoldering Plasma Cell Myeloma
Treatment laboratory biomarker analysis, Blood Collection, biospecimen collection
Clinical Study IdentifierNCT02726750
SponsorM.D. Anderson Cancer Center
Last Modified on26 January 2022


Yes No Not Sure

Inclusion Criteria

Patients with monoclonal gammopathy of unknown significance. Both criteria must be
Serum monoclonal protein < 3 g/dL or urinary monoclonal protein < 500 mg per 24 hours and clonal bone marrow plasma cells < 10%
Absence of myeloma defining events or amyloidosis
Patients with smoldering multiple myeloma. Both criteria must be met
Serum monoclonal protein >= 3 g/dL or urinary monoclonal protein >= 500 mg per 24 hours and/or clonal bone marrow plasma cells 10-60%
Absence of myeloma defining events or amyloidosis

Exclusion Criteria

Evidence of myeloma defining events or biomarkers of malignancy due to underlying plasma cell proliferative disorder meeting at least one of the following
Hypercalcemia: serum calcium > 0.25 mmol/L (> 1 mg/dL) higher than the upper limit of normal or > 2.75 mmol/L (> 11 mg/dL)
Renal Insufficiency: creatinine clearance < 40 ml/min or serum creatinine > 2 mg/dL
Anemia: hemoglobin value < 10 g/dL or 2 g/dL < normal reference
Bone lesions: one or more osteolytic lesions on skeletal radiography, computerized tomography (CT) or 2-deoxy-2[F-18] fluoro-D-glucose positron emission tomography CT (PET-CT)
Clonal bone marrow plasma cell percentage >= 60%
Involved:uninvolved serum free light chain ratio >= 100 measured by Freelite assay (The Binding Site Group, Birmingham, United Kingdom [UK])
> 1 focal lesions on magnetic resonance imaging (MRI) studies (each focal lesion must be 5 mm or more in size)
Prior or concurrent systemic treatment for asymptomatic monoclonal gammopathies
Bisphosphonates are permitted
Radiotherapy is not permitted
Prior treatment with chemotherapy or investigational agents for asymptomatic gammopathies is not permitted
Plasma cell leukemia
Uncontrolled intercurrent illness including but not limited to active infection or psychiatric illness/social situations that would compromise compliance with study requirements
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