iStopMM changes the definition of multiple myeloma precursor condition
- The findings of a new study show that the current reference intervals for diagnosing MGUS (monoclonal gammopathy of undetermined significance), a precursor to multiple myeloma, in patients with reduced kidney function are inaccurate.
- The research established new reference intervals, specifically developed for this group.
- The new reference intervals will have an enormous global impact on diagnosis and treatment of patients with multiple myeloma and related diseases.
Data from the major study iStopMM, by scientists from the University of Iceland and Landspítali University Hospital as well as other institutions, has been used to redefine MGUS. These findings have now been reported in one of the world's most respected journals in the field of blood diseases, Blood Cancer Journal, which is part of the Nature Portfolio. The researchers behind the study have changed the reference intervals for measuring free light chains in the blood of people with chronic kidney disease; these measurements are key to diagnosing and monitoring multiple myeloma, its precursors and other related diseases.
Among the authors of the paper are the doctors Þórir Einarsson Long and Sigurður Yngvi Kristinsson, who also work at the University of Iceland, but a large team of people worked on the research. Þórir and Sigurður Yngvi believe these are important findings since kidney function affects measurements of free light chains. This means that people with reduced kidney function have previously been misdiagnosed, leading to overdiagnosis and unnecessary follow up tests in this group.
The new reference intervals for light chains in the blood, adjusted for individuals with reduced kidney function, will make it much easier to interpret and understand measurements. This will reduce unnecessary testing, avoid needless worry for patients, and save the healthcare system money. The findings have already attracted significant international interest and will have an enormous global impact on diagnosis and treatment of patients with multiple myeloma and related diseases.
"We have had a strong and positive response to the paper, with doctors all over the world welcoming our new reference intervals and reporting they have already started using them in day-to-day clinical work. So it is clear that our work has already had and will continue to have an impact on patient treatment across the globe," says Þórir Long.
"It's very gratifying to see one of our primary goals with the iStopMM study coming to fruition. We aspired to improve and expand our understanding of MGUS and increase quality of life," says Sigurður Yngvi Kristinsson.
3600 diagnosed with MGUS
The national initiative iStopMM was launched in the autumn of 2016 as a collaboration between the University of Iceland, Landspítali University Hospital, the Icelandic Cancer Society and the Binding Site, and supported by the Black Swan Research Initiative. The goal of the study was to evaluate the impact of screening for multiple myeloma precursor conditions, investigate the causes and consequences of the disease and improve the lives of those diagnosed with multiple myeloma and seeking treatment.
The study, which is one of the largest in the world, is conducted by an interdisciplinary research team led by Sigurður Yngvi Kristinsson, professor of hematology at the University of Iceland Faculty of Medicine and specialist at Landspítali University Hospital. Everyone in Iceland born in 1975 or earlier was invited to take part and over 80,000 people gave informed consent.
About 75,000 samples have now been screened and just over 3,600 people have been diagnosed with MGUS, as well as almost 300 people with more advanced multiple myeloma or SMM (smoldering multiple myeloma). People with SMM are invited to take part in a treatment trial aimed at preventing the disease from progressing to multiple myeloma. Screening has made it possible to identify asymptomatic people and start drug treatment earlier than otherwise would have been possible. Participants diagnosed with MGUS are also offered monitoring.
