Multiple myeloma (MM) is an incurable hematological malignancy characterized by an M-protein shown in electrophoresis of the blood. Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant asymptomatic condition in which an individual has an M-protein, but no underlying malignancy. MGUS is present in 5-10% of the elderly and precedes all cases of MM, however, not all MGUS patients will progress to MM. An accurate method to predict which patients will progress to MM and related diseases is lacking. Thrombotic issues have recently become a major clinical problem in MM. In addition, we have found that individuals with MGUS have an increased risk of both venous and arterial thrombosis. The underlying mechanisms for the thrombosis risk in MM and MGUS patients remain unknown.
In this research project, we will study the well-defined, population-based AGES-RS, a longitudinal cohort study of 5,764 men and women in Iceland who have been screened with extensive clinical, laboratory and radiological examinations with focus on cardiovascular risk profile and diseases, bone disease, as well as all clinical events during follow-up. We will screen all individuals in the AGES-RS study for M-protein. The overall aims of the study proposal are to analyse morbidity and mortality among individuals with and without MGUS. We will then compare specific outcomes in individuals with M-protein (MGUS patients) versus those without. We aim to determine; what is the survival pattern for MGUS patients, what risk factors for malignant transformation (to MM or other malignancies) can be determined, and what risk factors for cardiovascular and bone disease do MGUS patients carry? By improving the prognostic models for MGUS we hope to be able to define high and low risk patients. Our results will hopefully shed light into several important aspects on MGUS and MM with special focus in the pathogenesis of thrombotic disease in MGUS and MM.