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<p>Recent studies have advanced the understanding of the pathogenesis of monoclonal gammopathy of uncertain significance (MGUS), describing the influence of a proinflammatory bone marrow environment on the risk of progression. While albumin is a known inflammatory prognostic biomarker in multiple myeloma, its role in MGUS has not been explored. We conducted a retrospective study to investigate the prognostic value of albumin in MGUS. Eight hundred and thirty-eight patients with MGUS were included: 71 (8.5%) presented hypoalbuminemia (≤3.5 g/dL) at diagnosis. Hypoalbuminemia was more common in men (63.4% <i>vs.</i> 49.3%; <i>P</i> = 0.025), older age (≥70 years: 74.6% <i>vs.</i> 57.2%; <i>P</i> = 0.005), and IgA isotype (33.8% <i>vs.</i> 21.4%; <i>P</i> = 0.018). These patients presented lower hemoglobin levels and higher creatinine values (<i>P</i> &lt; 0.001 and <i>P</i> &lt; 0.001). Serum M protein ≥ 1.5 g/dL (HR 18.9 [95% CI, 1.8–200.8]; <i>P</i> = 0.015) and hypoalbuminemia (HR 14.7 [95% CI, 1.7–124.7]; <i>P</i> = 0.014) were identified as independent prognostic factors for progression. In our series, Mayo Clinic and MGUS-<i>like</i> phenotype models were validated, and the incorporation of hypoalbuminemia into these models helped identify a subgroup of intermediate-risk patients with a higher risk of progression. In conclusion, if confirmed by independent studies, hypoalbuminemia could be integrated into existing prognostic models, improving risk stratification and guiding clinical decision-making.</p>

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Hypoalbuminemia: a new risk factor for progression in patients with monoclonal gammopathy of uncertain significance

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月24日

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  • Elena Alejo,
  • Verónica González-Calle,
  • Patricia Blázquez,
  • Borja Puertas,
  • Cristina Agulló,
  • Beatriz Rey-Búa,
  • Norma C. Gutiérrez,
  • Noemi Puig,
  • María-Victoria Mateos

摘要

Recent studies have advanced the understanding of the pathogenesis of monoclonal gammopathy of uncertain significance (MGUS), describing the influence of a proinflammatory bone marrow environment on the risk of progression. While albumin is a known inflammatory prognostic biomarker in multiple myeloma, its role in MGUS has not been explored. We conducted a retrospective study to investigate the prognostic value of albumin in MGUS. Eight hundred and thirty-eight patients with MGUS were included: 71 (8.5%) presented hypoalbuminemia (≤3.5 g/dL) at diagnosis. Hypoalbuminemia was more common in men (63.4% vs. 49.3%; P = 0.025), older age (≥70 years: 74.6% vs. 57.2%; P = 0.005), and IgA isotype (33.8% vs. 21.4%; P = 0.018). These patients presented lower hemoglobin levels and higher creatinine values (P < 0.001 and P < 0.001). Serum M protein ≥ 1.5 g/dL (HR 18.9 [95% CI, 1.8–200.8]; P = 0.015) and hypoalbuminemia (HR 14.7 [95% CI, 1.7–124.7]; P = 0.014) were identified as independent prognostic factors for progression. In our series, Mayo Clinic and MGUS-like phenotype models were validated, and the incorporation of hypoalbuminemia into these models helped identify a subgroup of intermediate-risk patients with a higher risk of progression. In conclusion, if confirmed by independent studies, hypoalbuminemia could be integrated into existing prognostic models, improving risk stratification and guiding clinical decision-making.