Risk Factors of Mailankody et al for Acute Myeloid Leukemia (AML) or Myelodysplastic Syndrome (MDS) Occurring in a Patient with Multiple Myeloma or Monoclonal Gammopathy of Unknown Significance (MGUS)
A patient with myeloma or monoclonal gammopathy of unknown significance (MGUS) is at significant risk for acute myeloid leukemia (AML) or the myelodysplastic syndrome (MDS). Mailankody et al identified risk factors for the progression to a second hematologic disorder. The authors are from National Cancer Institute (NCI), Washington Hospital Center, Karolinska University and Skane University Hospital (Malmo, Sweden).
Patient selection: multiple myeloma or MGUS
Parameters:
(1) type of monoclonal protein
(2) concentration of the monoclonal protein
Parameter
Finding
Points
type of monoclonal protein
IgA
1
IgG
1
IgM
0
concentration
< 1.5 g/dL
0
>= 1.5 g/dL
1
number of risk factors for AML or MDS =
= SUM(points for both parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 2
• The risk increases as the number of risk factors increases.
• The median time to AML/MDS was about 4 years after diagnosis of myeloma or MGUS.
Number of Risk Factors
Risk of AML/MDS
0
low
1
moderate
2
high
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