Monoclonal gammopathy of renal significance (MGRS): Real-world data on outcomes and prognostic factors

Gozzetti A, Guarnieri A, Zamagni E, Zakharova E, Coriu D, Bittrich M, Pika T, Tovar N, Schutz N, Ciofini S, Pena C, Rocchi S, Rassner M, Avivi I, Waszczuk-Gajda A, Chhabra S, Usnarska-Zubkiewicz L, Gonzalez-Calle V, Mateos MV, Bocchia M, Bigi F, Fullgraf H, Bhasin-Chhabra B, Gentile M, Davila J, Vesole DH, Cavo M, Thapa B, Crusoe E, Einsele H, Legiec W, Charlinski G, Jurczyszyn A (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Book Volume: 97

Pages Range: 877-884

Journal Issue: 7

DOI: 10.1002/ajh.26566

Abstract

Monoclonal gammopathy of renal significance (MGRS) is a recognized clinical entity. Literature regarding treatment and its outcomes in MGRS is sparse due to the rarity and misdiagnosis of MGRS. We retrospectively analyzed 280 adults with an MGRS diagnosis from 2003 to 2020 across 19 clinical centers from 12 countries. All cases required renal biopsy for the pathological diagnosis of MGRS. Amyloidosis-related to MGRS (MGRS-A) was present in 180 patients; nonamyloidosis MGRS (MGRS-NA), including a broad spectrum of renal pathologies, was diagnosed in 100 patients. The median overall survival in the studied cohort was 121.0 months (95% CI: 105.0–121.0). Patients with MGRS-A had a shorter overall survival than patients with MGRS-NA (HR = 0.41, 95%CI: 0.25–0.69; p = 0.0007). Both hematologic and renal responses were associated with longer survival. Achievement of ≥VGPR was generally predictive of a renal response (OR = 8.03 95%CI: 4.04–115.96; p < 0.0001), one-fourth of patients with ≥VGPR were renal nonresponders. In MGRS-A, factors associated with poor prognosis included elevated levels of creatinine, beta-2-microglobulin, and hemodialysis at diagnosis. In MGRS-NA, only age >65 years was associated with increased risk of death. Treatments provided similar hematologic response rates in both types of MGRS. Autologous stem cell transplantation led to better response than other treatments. This multicenter and international effort is currently the largest report on MGRS.

Involved external institutions

Università degli Studi di Siena (UNISI) / University of Siena Italy (IT) University Hospital Siena Italy (IT) University of Bologna / Università di Bologna Italy (IT) Botkin Hospital / Городская клиническая больница имени С. П. Боткина Russian Federation (RU) Carol Davila University of Medicine and Pharmacy / Universitatea de Medicină și Farmacie „Carol Davila” (UMF București) Romania (RO) Universitätsklinikum Würzburg Germany (DE) University Hospital Olomouc / Fakultní Nemocnice Olomouc Czech Republic (CZ) Universitat de Barcelona (UB) / University of Barcelona Spain (ES) Hospital del Salvador Chile (CL) Albert-Ludwigs-Universität Freiburg Germany (DE) Tel Aviv University Israel (IL) Wrocław Medical University / Uniwersytet Medyczny we Wrocławiu Poland (PL) Medical College of Wisconsin (MCW) United States (USA) (US) University of Salamanca / Universidad de Salamanca Spain (ES) Azienda Ospedaliera di Cosenza Italy (IT) Complejo asistencial de Ávila Spain (ES) Hackensack Meridian School of Medicine (HMSOM) United States (USA) (US) Universidade Federal da Bahia Brazil (BR) Saint Jan of Dukla Oncology Centre of the Lublin Region / St. John of Dukla Cancer Centre Poland (PL) University of Warmia and Mazury in Olsztyn Poland (PL) Jagiellonian University Medical College Poland (PL)

How to cite

APA:

Gozzetti, A., Guarnieri, A., Zamagni, E., Zakharova, E., Coriu, D., Bittrich, M.,... Jurczyszyn, A. (2022). Monoclonal gammopathy of renal significance (MGRS): Real-world data on outcomes and prognostic factors. American Journal of Hematology, 97(7), 877-884. https://dx.doi.org/10.1002/ajh.26566

MLA:

Gozzetti, Alessandro, et al. "Monoclonal gammopathy of renal significance (MGRS): Real-world data on outcomes and prognostic factors." American Journal of Hematology 97.7 (2022): 877-884.

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