Serum BCMA levels predict outcomes in MGUS and smoldering myeloma patients

Blood Cancer J. 2021 Jun 24;11(6):120. doi: 10.1038/s41408-021-00505-4.

Abstract

Soluble BCMA (sBCMA) levels are elevated in monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). However, the association between sBCMA levels and prognosis in MGUS and SMM has not been studied. We retrospectively analyzed sBCMA levels in stored samples from 99 MGUS and 184 SMM patients. Baseline sBCMA levels were significantly higher in MGUS and SMM patients progressing to MM during clinical follow up. When stratified according to the median baseline sBCMA level for each cohort, higher levels were associated with a shorter PFS for MGUS (HR 3.44 comparing sBCMA ≥77 vs <77 ng/mL [95% CI 2.07-5.73, p < 0.001] and SMM (HR 2.0 comparing sBCMA ≥128 vs <128 ng/mL, 95% 1.45-2.76, p < 0.001) patients. The effect of sBCMA on PFS was similar even after adjusting for the baseline MGUS or SMM risk stratification. We evaluated paired serum samples and found that sBCMA increased significantly in MGUS and SMM patients who eventually progressed to MM, whereas among MGUS non-progressors the sBCMA level remained stable. While our results require independent validation, they suggest that sBCMA may be a useful biomarker to identify MGUS and SMM patients at increased risk of progression to MM independent of the established risk models.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • B-Cell Maturation Antigen / blood*
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Monoclonal Gammopathy of Undetermined Significance* / blood
  • Monoclonal Gammopathy of Undetermined Significance* / mortality
  • Neoplasm Proteins / blood*
  • Predictive Value of Tests
  • Smoldering Multiple Myeloma* / blood
  • Smoldering Multiple Myeloma* / mortality
  • Survival Rate

Substances

  • B-Cell Maturation Antigen
  • Neoplasm Proteins
  • TNFRSF17 protein, human