Monoclonal gammopathy of undetermined significance and the risk of thrombotic events: Results from iStopMM, a prospective population‐based screening study
Monoclonal gammopathy of undetermined significance (MGUS) is the asymptomatic precursor of multiple myeloma and related diseases but has also been associated with thrombosis. Prior studies have not been based on screened cohorts leading to bias. We assessed the risk of thrombosis in a cohort of 75 422 individuals over 40 years old who were screened for MGUS in Iceland. We also evaluated the association of M protein concentration with thrombotic risk. A total of 3668 participants had MGUS. After a median follow-up of ~3.7 years, 124 venous and 252 arterial thrombotic events (10.3 and 21.0 per 1000 person years respectively) were observed in the MGUS group, compared to 1509 and 3471 in the non-MGUS group (6.0 and 13.8 per 1000 person years respectively). After adjusting for multiple confounders, MGUS was associated with an increased risk of venous thrombosis (hazard ratio [HR] = 1.43; 95% confidence interval [CI]: 1.19-1.73) but not arterial thrombosis (HR = 0.96; 95% CI: 0.87-1.13). M protein concentration was not associated with venous (p = 0.72) or arterial (p = 0.95) thrombosis. The findings show, in a screened cohort, that MGUS is associated with venous, but not arterial, thrombosis. Furthermore, they suggest that there is a subset of individuals with MGUS with subclinical monoclonal gammopathy of thrombotic significance.
Authors
- Sigurður Y. Kristinsson (ORCID: https://orcid.org/0000-0002-4964-7476)
- Róbert Pálmason
- Elías Eyþórsson (ORCID: https://orcid.org/0000-0002-0277-7628)
- Páll T. Önundarson (ORCID: https://orcid.org/0000-0002-5342-9148)
- Malin L. Hultcrantz (ORCID: https://orcid.org/0000-0002-9045-6495)
- Brynjar Viðarsson
- Jón Þórir Óskarsson (ORCID: https://orcid.org/0000-0002-9201-1166)
- Brian G.M. Durie (ORCID: https://orcid.org/0000-0002-9883-3769)
- Þórir Einarsson Long (ORCID: https://orcid.org/0000-0003-2377-7886)
- Ingigerður Sverrisdóttir (ORCID: https://orcid.org/0000-0003-2353-573X)
- Margrét Sigurðardóttir (ORCID: https://orcid.org/0000-0001-8719-0430)
- Ingunn Þorsteinsdóttir
- Andri Ólafsson (ORCID: https://orcid.org/0000-0002-7381-8431)
- Alessandro Gasparini (ORCID: https://orcid.org/0000-0002-8319-7624)
- Bjarni A. Agnarsson (ORCID: https://orcid.org/0000-0001-7721-9965)
- Runólfur Pálsson (ORCID: https://orcid.org/0000-0001-6763-1702)
- Sigrún Þorsteinsdóttir (ORCID: https://orcid.org/0000-0001-8412-7049)
- Sæmundur Rögnvaldsson (ORCID: https://orcid.org/0000-0003-2162-8414)
- Þorvarður Jón Löve (ORCID: https://orcid.org/0000-0002-2680-6120)
- Ola Landgren (ORCID: https://orcid.org/0000-0001-6485-4839)
- Ólafur S. Indridason (ORCID: https://orcid.org/0000-0001-8509-6598)
- Stephen Harding
- Isleifur Olafsson
- Ásbjörn Jónsson
Institutions
- Reykjavík University (IS)
- Cedars-Sinai Medical Center (US)
- Memorial Sloan Kettering Cancer Center (US)
- University of Miami (US)
- University of Iceland (IS)
- Sahlgrenska University Hospital (SE)
- Rigshospitalet (DK)
- Akureyri Hospital (IS)
- National University Hospital of Iceland (IS)
- Skåne University Hospital (SE)
- Sylvester Comprehensive Cancer Center (US)
Publication Details
- Journal
- British Journal of Haematology
- Published
- 2024-12-25
- DOI
- https://doi.org/10.1111/bjh.19957
- Citations
- 5
- Primary Topic
- Multiple Myeloma Research and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 2.27
Funders
- International Myeloma Foundation
- Tow Foundation
- Landspítali Háskólasjúkrahús
- Rannís
- Horizon 2020 Framework Programme