Investigating the significance of multiple myeloma and its precursors

Clinical aspects of these conditions are generally well understood, however other traits such as epidemiology and psychosocial impacts are not. This thesis reports on a series of studies which aimed to build on under-researched aspects of MGUS, SMM and MM and build a clearer picture of the “significance” of each condition to populations and individuals.<br><br>Following a review of the literature to identify research needs, a systematic review of MGUS’s rate of progression to malignancy was conducted.

Clinical guidelines for MGUS are based primarily on one study, however n=42 studies were identified and analysed via meta-analysis and narrative synthesis, indicating a wide variety of malignant progression rates globally.<br><br>Current clinical coding practices classify SMM and MM under the same disease label, which has hindered the study of SMM epidemiology. As a potential solution, a previously-developed algorithm to distinguish the conditions was trialled in an exploratory analysis of the Northern Ireland Cancer Registry.