Abstract | PURPOSE: PATIENTS AND METHODS: Between 2003 and 2011, 331 eligible patients with IgG/A monoclonal gammopathy were enrolled in a prospective observational trial (SWOG S0120). RESULTS: Of 331 eligible patients, 57 (17%) were of AA descent. The risk of transformation to clinical malignancy in AA patients was significantly lower than in non-AA cohort (2-year risk 5% vs. 15%; 5-year risk 13% vs. 24%; log-rank P = 0.047). Differences in risk were evident for both MGUS and asymptomatic multiple myeloma. Gene expression profile (GEP) of CD138-purified plasma cells revealed that all molecular multiple myeloma subsets can be identified in both cohorts. However, the proportion of patients with high-risk GEP risk score (GEP-70 gene risk > -0.26) was lower in the AA cohort (0% vs. 33%, P = 0.01). AA cohorts also have higher levels of antibodies against Epstein-Barr nuclear antigen-1 ( EBNA-1; P < 0.001). CONCLUSIONS: These data provide the first prospective evidence that multiple myeloma precursor states in AA patients may have lower risk of disease compared with non-AA counterparts with lower incidence of high-risk GEP and increased EBV seropositivity. Race-dependent differences in biology and clinical risk of gammopathy may impact optimal management of these patients.
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Authors | Madhav V Dhodapkar, Rachael Sexton, Antje Hoering, Frits Van Rhee, Bart Barlogie, Robert Orlowski |
Journal | Clinical cancer research : an official journal of the American Association for Cancer Research
(Clin Cancer Res)
Vol. 26
Issue 22
Pg. 5814-5819
(11 15 2020)
ISSN: 1557-3265 [Electronic] United States |
PMID | 32816893
(Publication Type: Clinical Trial, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | ©2020 American Association for Cancer Research. |
Chemical References |
- Epstein-Barr Virus Nuclear Antigens
- Syndecan-1
- EBV-encoded nuclear antigen 1
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Topics |
- Black or African American
(genetics)
- Aged
- Epstein-Barr Virus Infections
(complications, epidemiology, genetics, virology)
- Epstein-Barr Virus Nuclear Antigens
(blood, genetics)
- Female
- Gene Expression Regulation, Neoplastic
(genetics)
- Genomics
- Humans
- Male
- Middle Aged
- Monoclonal Gammopathy of Undetermined Significance
(complications, epidemiology, genetics, virology)
- Multiple Myeloma
(complications, epidemiology, genetics, virology)
- Race Factors
- Syndecan-1
(blood)
- Transcriptome
(genetics)
- White People
(genetics)
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