Prevalence of smoldering multiple myeloma based on nationwide screening

Sigrún Þorsteinsdóttir; Gauti Kjartan Gíslason; Thor Aspelund; Sæmundur Rögnvaldsson; Jón Þórir Óskarsson; Guðrún Ásta Sigurðardóttir; Ásdís Rósa Þórðardóttir; Brynjar Viðarsson; Páll Torfi Önundarson; Bjarni Agnar Agnarsson; Margrét Sigurðardóttir; Ingunn Þorsteinsdóttir; Ísleifur Ólafsson; Elías Sæbjörn Eyþórsson; Ásbjörn Jónsson; Oscar Berlanga; Malin Hulcrantz; Brian G.M. Durie; Þorvarður Jón Löve; Stephen Harding; Ola Landgren; Sigurður Yngvi Kristinsson

doi:10.1038/s41591-022-02183-6

Prevalence of smoldering multiple myeloma based on nationwide screening

Sigrún Þorsteinsdóttir, Gauti Kjartan Gíslason, Thor Aspelund, Sæmundur Rögnvaldsson, Jón Þórir Óskarsson, Guðrún Ásta Sigurðardóttir, Ásdís Rósa Þórðardóttir, Brynjar Viðarsson, Páll Torfi Önundarson, Bjarni Agnar Agnarsson, Margrét Sigurðardóttir, Ingunn Þorsteinsdóttir, Ísleifur Ólafsson, Elías Sæbjörn Eyþórsson, Ásbjörn Jónsson, Oscar Berlanga, Malin Hulcrantz, Brian G.M. Durie, Þorvarður Jón Löve, Stephen HardingOla Landgren, Sigurður Yngvi Kristinsson

University of Iceland

Research output: Contribution to journal › Article › peer-review

Abstract

Smoldering multiple myeloma (SMM) is an asymptomatic precursor to multiple myeloma. Here we define the epidemiological characteristics of SMM in the general population in Iceland. The iStopMM study (ClinicalTrials.gov ID: NCT03327597) is a nationwide screening study for multiple myeloma precursors where all residents in Iceland 40 years or older were invited to participate. SMM was defined as 10–60% bone marrow plasma cells and/or monoclonal (M) protein concentration ≥3 g dl⁻¹, in the absence of myeloma-defining events. Of the 80,759 who gave informed consent to participate, 75,422 (93%) were screened. The prevalence of SMM in the total population was 0.53% (95% confidence interval (CI) = 0.49–0.57%) in individuals 40 years or older. In men and women, the prevalence of SMM was 0.67% (95% CI = 0.62–0.73%) and 0.39% (95% CI = 0.35–0.43%), respectively; it increased with age in both sexes. For the 193 individuals with SMM, median age was 70 years (range 44–92 years) and 60% were males. The mean M protein concentration of individuals with SMM was 0.62 g dl⁻¹ (range 0.01–3.5 g dl⁻¹) and 73% had 11–20% bone marrow plasma cell infiltration. The high prevalence of SMM has implications for future treatment policies in multiple myeloma as the evidence supporting treatment initiation at the SMM stage is emerging.

Original language	English
Pages (from-to)	467-472
Number of pages	6
Journal	Nature Medicine
Volume	29
Issue number	2
DOIs	https://doi.org/10.1038/s41591-022-02183-6
Publication status	Published - 6 Feb 2023

Bibliographical note

Funding Information: The iStopMM study is funded by the Black Swan Research Initiative by the International Myeloma Foundation and the Icelandic Centre for Research (grant no. 173857). This project also received funding from the European Research Council under the European Union’s Horizon 2020 research and innovation program (grant no. 716677), the International Myeloma Society, the Paula and Rodger Riney Foundation Translational Research Award and the Leukemia & Lymphoma Society Career Development Program Scholar in Clinical Research Award. Screening tests were performed by The Binding Site. Additional funding was provided by the University of Iceland, Landspítali University Hospital and the Icelandic Cancer Society. The funders had no role in study design, data collection, data analysis, data interpretation or manuscript writing. We thank all the participants in the iStopMM study. Publisher Copyright: © 2023, The Author(s), under exclusive licence to Springer Nature America, Inc.

Other keywords

Adult
Aged
Aged, 80 and over
Disease Progression
Female
Humans
Middle Aged
Multiple Myeloma/therapy
Prevalence
Risk Factors
Smoldering Multiple Myeloma

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10.1038/s41591-022-02183-6

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Þorsteinsdóttir, S., Gíslason, G. K., Aspelund, T., Rögnvaldsson, S., Óskarsson, J. Þ., Sigurðardóttir, G. Á., Þórðardóttir, Á. R., Viðarsson, B., Önundarson, P. T., Agnarsson, B. A., Sigurðardóttir, M., Þorsteinsdóttir, I., Ólafsson, Í., Eyþórsson, E. S., Jónsson, Á., Berlanga, O., Hulcrantz, M., Durie, B. G. M., Löve, Þ. J., ... Kristinsson, S. Y. (2023). Prevalence of smoldering multiple myeloma based on nationwide screening. Nature Medicine, 29(2), 467-472. https://doi.org/10.1038/s41591-022-02183-6

@article{efc62a6807434c028d8d15f85b0ef5d1,

title = "Prevalence of smoldering multiple myeloma based on nationwide screening",

abstract = "Smoldering multiple myeloma (SMM) is an asymptomatic precursor to multiple myeloma. Here we define the epidemiological characteristics of SMM in the general population in Iceland. The iStopMM study (ClinicalTrials.gov ID: NCT03327597) is a nationwide screening study for multiple myeloma precursors where all residents in Iceland 40 years or older were invited to participate. SMM was defined as 10–60\% bone marrow plasma cells and/or monoclonal (M) protein concentration ≥3 g dl−1, in the absence of myeloma-defining events. Of the 80,759 who gave informed consent to participate, 75,422 (93\%) were screened. The prevalence of SMM in the total population was 0.53\% (95\% confidence interval (CI) = 0.49–0.57\%) in individuals 40 years or older. In men and women, the prevalence of SMM was 0.67\% (95\% CI = 0.62–0.73\%) and 0.39\% (95\% CI = 0.35–0.43\%), respectively; it increased with age in both sexes. For the 193 individuals with SMM, median age was 70 years (range 44–92 years) and 60\% were males. The mean M protein concentration of individuals with SMM was 0.62 g dl−1 (range 0.01–3.5 g dl−1) and 73\% had 11–20\% bone marrow plasma cell infiltration. The high prevalence of SMM has implications for future treatment policies in multiple myeloma as the evidence supporting treatment initiation at the SMM stage is emerging.",

keywords = "Adult, Aged, Aged, 80 and over, Disease Progression, Female, Humans, Middle Aged, Multiple Myeloma/therapy, Prevalence, Risk Factors, Smoldering Multiple Myeloma",

author = "Sigr{\'u}n {\TH}orsteinsd{\'o}ttir and G{\'i}slason, \{Gauti Kjartan\} and Thor Aspelund and S{\ae}mundur R{\"o}gnvaldsson and {\'O}skarsson, \{J{\'o}n {\TH}{\'o}rir\} and Sigur{\dh}ard{\'o}ttir, \{Gu{\dh}r{\'u}n {\'A}sta\} and {\TH}{\'o}r{\dh}ard{\'o}ttir, \{{\'A}sd{\'i}s R{\'o}sa\} and Brynjar Vi{\dh}arsson and {\"O}nundarson, \{P{\'a}ll Torfi\} and Agnarsson, \{Bjarni Agnar\} and Margr{\'e}t Sigur{\dh}ard{\'o}ttir and Ingunn {\TH}orsteinsd{\'o}ttir and {\'I}sleifur {\'O}lafsson and Ey{\th}{\'o}rsson, \{El{\'i}as S{\ae}bj{\"o}rn\} and {\'A}sbj{\"o}rn J{\'o}nsson and Oscar Berlanga and Malin Hulcrantz and Durie, \{Brian G.M.\} and L{\"o}ve, \{{\TH}orvar{\dh}ur J{\'o}n\} and Stephen Harding and Ola Landgren and Kristinsson, \{Sigur{\dh}ur Yngvi\}",

note = "Funding Information: The iStopMM study is funded by the Black Swan Research Initiative by the International Myeloma Foundation and the Icelandic Centre for Research (grant no. 173857). This project also received funding from the European Research Council under the European Union{\textquoteright}s Horizon 2020 research and innovation program (grant no. 716677), the International Myeloma Society, the Paula and Rodger Riney Foundation Translational Research Award and the Leukemia \& Lymphoma Society Career Development Program Scholar in Clinical Research Award. Screening tests were performed by The Binding Site. Additional funding was provided by the University of Iceland, Landsp{\'i}tali University Hospital and the Icelandic Cancer Society. The funders had no role in study design, data collection, data analysis, data interpretation or manuscript writing. We thank all the participants in the iStopMM study. Publisher Copyright: {\textcopyright} 2023, The Author(s), under exclusive licence to Springer Nature America, Inc.",

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doi = "10.1038/s41591-022-02183-6",

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Þorsteinsdóttir, S, Gíslason, GK, Aspelund, T , Rögnvaldsson, S , Óskarsson, JÞ, Sigurðardóttir, GÁ, Þórðardóttir, ÁR, Viðarsson, B , Önundarson, PT, Agnarsson, BA, Sigurðardóttir, M , Þorsteinsdóttir, I , Ólafsson, Í, Eyþórsson, ES, Jónsson, Á, Berlanga, O, Hulcrantz, M, Durie, BGM, Löve, ÞJ, Harding, S, Landgren, O & Kristinsson, SY 2023, 'Prevalence of smoldering multiple myeloma based on nationwide screening', Nature Medicine, vol. 29, no. 2, pp. 467-472. https://doi.org/10.1038/s41591-022-02183-6

TY - JOUR

T1 - Prevalence of smoldering multiple myeloma based on nationwide screening

AU - Þorsteinsdóttir, Sigrún

AU - Gíslason, Gauti Kjartan

AU - Aspelund, Thor

AU - Rögnvaldsson, Sæmundur

AU - Óskarsson, Jón Þórir

AU - Sigurðardóttir, Guðrún Ásta

AU - Þórðardóttir, Ásdís Rósa

AU - Viðarsson, Brynjar

AU - Önundarson, Páll Torfi

AU - Agnarsson, Bjarni Agnar

AU - Sigurðardóttir, Margrét

AU - Þorsteinsdóttir, Ingunn

AU - Ólafsson, Ísleifur

AU - Eyþórsson, Elías Sæbjörn

AU - Jónsson, Ásbjörn

AU - Berlanga, Oscar

AU - Hulcrantz, Malin

AU - Durie, Brian G.M.

AU - Löve, Þorvarður Jón

AU - Harding, Stephen

AU - Landgren, Ola

AU - Kristinsson, Sigurður Yngvi

N1 - Funding Information: The iStopMM study is funded by the Black Swan Research Initiative by the International Myeloma Foundation and the Icelandic Centre for Research (grant no. 173857). This project also received funding from the European Research Council under the European Union’s Horizon 2020 research and innovation program (grant no. 716677), the International Myeloma Society, the Paula and Rodger Riney Foundation Translational Research Award and the Leukemia & Lymphoma Society Career Development Program Scholar in Clinical Research Award. Screening tests were performed by The Binding Site. Additional funding was provided by the University of Iceland, Landspítali University Hospital and the Icelandic Cancer Society. The funders had no role in study design, data collection, data analysis, data interpretation or manuscript writing. We thank all the participants in the iStopMM study. Publisher Copyright: © 2023, The Author(s), under exclusive licence to Springer Nature America, Inc.

PY - 2023/2/6

Y1 - 2023/2/6

N2 - Smoldering multiple myeloma (SMM) is an asymptomatic precursor to multiple myeloma. Here we define the epidemiological characteristics of SMM in the general population in Iceland. The iStopMM study (ClinicalTrials.gov ID: NCT03327597) is a nationwide screening study for multiple myeloma precursors where all residents in Iceland 40 years or older were invited to participate. SMM was defined as 10–60% bone marrow plasma cells and/or monoclonal (M) protein concentration ≥3 g dl−1, in the absence of myeloma-defining events. Of the 80,759 who gave informed consent to participate, 75,422 (93%) were screened. The prevalence of SMM in the total population was 0.53% (95% confidence interval (CI) = 0.49–0.57%) in individuals 40 years or older. In men and women, the prevalence of SMM was 0.67% (95% CI = 0.62–0.73%) and 0.39% (95% CI = 0.35–0.43%), respectively; it increased with age in both sexes. For the 193 individuals with SMM, median age was 70 years (range 44–92 years) and 60% were males. The mean M protein concentration of individuals with SMM was 0.62 g dl−1 (range 0.01–3.5 g dl−1) and 73% had 11–20% bone marrow plasma cell infiltration. The high prevalence of SMM has implications for future treatment policies in multiple myeloma as the evidence supporting treatment initiation at the SMM stage is emerging.

AB - Smoldering multiple myeloma (SMM) is an asymptomatic precursor to multiple myeloma. Here we define the epidemiological characteristics of SMM in the general population in Iceland. The iStopMM study (ClinicalTrials.gov ID: NCT03327597) is a nationwide screening study for multiple myeloma precursors where all residents in Iceland 40 years or older were invited to participate. SMM was defined as 10–60% bone marrow plasma cells and/or monoclonal (M) protein concentration ≥3 g dl−1, in the absence of myeloma-defining events. Of the 80,759 who gave informed consent to participate, 75,422 (93%) were screened. The prevalence of SMM in the total population was 0.53% (95% confidence interval (CI) = 0.49–0.57%) in individuals 40 years or older. In men and women, the prevalence of SMM was 0.67% (95% CI = 0.62–0.73%) and 0.39% (95% CI = 0.35–0.43%), respectively; it increased with age in both sexes. For the 193 individuals with SMM, median age was 70 years (range 44–92 years) and 60% were males. The mean M protein concentration of individuals with SMM was 0.62 g dl−1 (range 0.01–3.5 g dl−1) and 73% had 11–20% bone marrow plasma cell infiltration. The high prevalence of SMM has implications for future treatment policies in multiple myeloma as the evidence supporting treatment initiation at the SMM stage is emerging.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Disease Progression

KW - Female

KW - Humans

KW - Middle Aged

KW - Multiple Myeloma/therapy

KW - Prevalence

KW - Risk Factors

KW - Smoldering Multiple Myeloma

UR - https://www.scopus.com/pages/publications/85147493218

U2 - 10.1038/s41591-022-02183-6

DO - 10.1038/s41591-022-02183-6

M3 - Article

C2 - 36747117

SN - 1078-8956

VL - 29

SP - 467

EP - 472

JO - Nature Medicine

JF - Nature Medicine

IS - 2

ER -

Prevalence of smoldering multiple myeloma based on nationwide screening

Abstract

Bibliographical note

Other keywords

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