A new large-scale data analysis shows that monitoring blood cancer before symptoms emerge may nearly double survival times compared with patients diagnosed only after disease onset.
A research team led by professors Seong-Su Park and Chang-Ki Min (Catholic University Seoul St. Mary’s Hospital) and professors Seung-Hoon Han and Su-In Choi (Catholic University) analyzed national health insurance data from 2009 to 2022 involving more than 23,000 multiple myeloma patients.
They found that early detection and management of the blood cancer’s precursor conditions significantly improved long-term outcomes, and the results were published Tuesday in the Blood Cancer Journal.
Multiple myeloma is a refractory blood cancer that arises from plasma cells in the bone marrow and commonly leads to bone damage, anemia, kidney failure and other serious complications.
Around 2,000 new cases are diagnosed in South Korea each year.
Precursor Conditions and Survival
The investigators grouped patients into three categories based on their clinical history:
- Monoclonal gammopathy of undetermined significance (MGUS)
- — a pre-cancer condition in which abnormal monoclonal proteins appear in the blood but no organ damage is present.
- Smoldering (asymptomatic) multiple myeloma — early cancer with increased plasma cells but without symptoms requiring immediate treatment.
- Direct multiple myeloma diagnosis without prior recognition of precursor stages.
The median overall survival differed notably across these groups:
- MGUS followed by multiple myeloma: ~7.9 years
- Smoldering myeloma progressed to full disease: ~5.5 years
- Direct diagnosis with no precursor tracking: ~4.4 years
After adjusting for age, comorbidities and clinical biases (including lead-time bias),
the team found that patients monitored from the precursor stage had about 47% lower risk of death than those diagnosed only after symptoms emerged.
Why Early Awareness Matters
MGUS is not cancer, but it is known internationally as the precursor state to multiple myeloma.
In most people with MGUS — about 1% per year — the condition can progress to cancer if undetected.
In follow-up studies outside Korea, clinical monitoring of MGUS has been associated with better multiple myeloma survival,
likely because progression is caught earlier and treatment is started before severe organ damage develops.
Monitoring typically involves periodic blood tests (including serum protein levels and other markers) at regular intervals, tailored to individual risk factors.
Clinical Implications and Limitations
Researchers caution that finding MGUS or smoldering myeloma doesn’t automatically mean a person will get full-blown multiple myeloma — many cases remain stable without progression for years.
Over-screening people without symptoms might cause unnecessary anxiety.
Nonetheless, for individuals already identified with a precursor condition,
structured surveillance and risk assessment may contribute to earlier cancer diagnosis and improved survival prospects.
Background Research
Past cohort studies in other populations have reported that a significant proportion of MGUS cases progress to multiple myeloma over time
and that close follow-up is important for detecting early disease transformation and managing comorbid conditions.
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multiple myeloma, MGUS, smoldering multiple myeloma,
blood cancer, precursor condition, early monitoring, survival rate,
hematologic malignancy, plasma cell disorder, cancer prevention