Faculty Collaboration Database

Monoclonal gammopathy of renal significance (MGRS): Real-world data on outcomes and prognostic factors. Am J Hematol 2022 Jul;97(7):877-884

Date

04/08/2022

Pubmed ID

35389534

Pubmed Central ID

PMC9324084

DOI

10.1002/ajh.26566

Scopus ID

2-s2.0-85128391689 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

Monoclonal gammopathy of renal significance (MGRS) is a recognized clinical entity. Literature regarding treatment and its outcomes in MGRS is sparse due to the rarity and misdiagnosis of MGRS. We retrospectively analyzed 280 adults with an MGRS diagnosis from 2003 to 2020 across 19 clinical centers from 12 countries. All cases required renal biopsy for the pathological diagnosis of MGRS. Amyloidosis-related to MGRS (MGRS-A) was present in 180 patients; nonamyloidosis MGRS (MGRS-NA), including a broad spectrum of renal pathologies, was diagnosed in 100 patients. The median overall survival in the studied cohort was 121.0 months (95% CI: 105.0-121.0). Patients with MGRS-A had a shorter overall survival than patients with MGRS-NA (HR = 0.41, 95%CI: 0.25-0.69; p = 0.0007). Both hematologic and renal responses were associated with longer survival. Achievement of ≥VGPR was generally predictive of a renal response (OR = 8.03 95%CI: 4.04-115.96; p < 0.0001), one-fourth of patients with ≥VGPR were renal nonresponders. In MGRS-A, factors associated with poor prognosis included elevated levels of creatinine, beta-2-microglobulin, and hemodialysis at diagnosis. In MGRS-NA, only age >65 years was associated with increased risk of death. Treatments provided similar hematologic response rates in both types of MGRS. Autologous stem cell transplantation led to better response than other treatments. This multicenter and international effort is currently the largest report on MGRS.

Author List

Gozzetti A, Guarnieri A, Zamagni E, Zakharova E, Coriu D, Bittrich M, Pika T, Tovar N, Schutz N, Ciofini S, Peña C, Rocchi S, Rassner M, Avivi I, Waszczuk-Gajda A, Chhabra S, Usnarska-Zubkiewicz L, González-Calle V, Mateos MV, Bocchia M, Bigi F, Füllgraf H, Bhasin-Chhabra B, Gentile M, Davila J, Vesole DH, Cavo M, Thapa B, Crusoe E, Einsele H, Legiec W, Charliński G, Jurczyszyn A

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Hematopoietic Stem Cell Transplantation
Humans
Kidney Diseases
Monoclonal Gammopathy of Undetermined Significance
Paraproteinemias
Precancerous Conditions
Prognosis
Retrospective Studies
Transplantation, Autologous