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Creating of prognostic panel in patients with monoclonal gammopathy of undetermined significance with a target to prevent the risk of malignant transformation.

Project Objectives and Priorities
Development of a prognostic panel for patients with monoclonal gammopathy of unknown significance (MGUS) is important for delaying or preventing the progression of this disorder into multiple myeloma (MM). Preliminary findings suggest that it should be possible to identify a high-risk subgroup of MGUS patients. The objectives of our proposal are to confirm the validity of known parameters that can be used to distinguish the malignant and the benign types of MGUS. Our efforts will be also aimed at identification and validation of new risk factors for malignant transformation. Using these parameters, we intend to identify high risk patients who have a 90% probability of progression to a full-blown cancer within 3 years. The identification of these patients early in the course of their disease will provide a basis for other experimental projects aiming to prevent the malignant transformation.

Development of a prognostic panel for patients with monoclonal gammopathy of unknown significance using conventional risk factors for malignant transformation as well as novel parameters based on genomic and flowcytometric analysis. Early identification of patients at a high risk of malignant transformation into established cancer. Creation of a sensitive prediction tool for malignant transformation of MGUS as a first step towards prophylactic experimental

1. Objectives of the proposed project
1.1. Analysis of validity of known risk factors distinguishing benign from malignant MGUS
1.2. Analysis of the value of flowcytometry for early identification of the high-risk group
1.3. Evaluation of potential novel flowcytometic risk factors
1.4. Evaluation of potential novel cytogenetic factors
1.5. Proposal of guidelines for tailored approach including prophylaxis, follow-up, and treatment strategies for groups with different risks.