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Volume 357:1048-1050 September 6, 2007 Number 10
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Smoldering Multiple Myeloma

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by Kyle, R. A.
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To the Editor: Kyle et al. (June 21 issue)1 propose a clinically useful risk-stratification model of progression from smoldering multiple myeloma to overt multiple myeloma. Gene-expression–signature data might enhance their model.

Recent studies have shown that a 50-gene panel can distinguish monoclonal gammopathy of undetermined significance (MGUS)–like multiple myeloma (better prognosis) from non–MGUS-like multiple myeloma.2 Studies have also shown that multiple myeloma can be divided into eight distinct molecular subtypes with different prognoses.3 Smoldering multiple myeloma with gains of chromosome 1q21 is associated with an increased risk of conversion to multiple myeloma,4 and a gene-expression signature of high-risk disease, reflecting . . . [Full Text of this Article]



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