How well do gene-based assays predict risk of progression from smoldering to symptomatic multiple my

Multiple myeloma (MM) is one of those lymphomas you’d encounter usually in a very late stage of the disease which makes intervention very hard and treatment equally harder. This difficulty makes early detection of precursor condition(s) very demanding and one such phase is Monoclonal Gammopathy of Undetermined Significance (MGUS) although unfortunately it is asymptomatic. MGUS often progresses to a mildly symptomatic phase called Smoldering/Symptomatic Multiple Myeloma (SMM) making it perfect for early detection and subsequent intervention. There have been quite a handful number of studies focusing on genetics of this disease to understand some characteristics that can flag early prognosis to SMM from MGUS. To this end the study in concern discusses a predicting mechanism based on only four potentially causal genes (GEP4) and also shows it’s efficacy compared to previous algorithms (GEP70, Mayo Clinic model). The results depicted are promising but nonetheless suffers from lack of power and simultaneously with limitation in replicative potential. The silver lining is, this project gives way to a very cost-effective and specialized prediction model that can be employed individually to patients paving the way to a more personalized diagnostic environment.

Original article: Khan et al (2015) Four genes predict high risk of progression from smoldering to symptomatic multiple myeloma (SWOGS0120) Haematologica. 2015 Sep;100(9):1214-21.