Þjóðarátak gegn krabbameinum - Blóðskimun til bjargar - verkefni lokið

Fréttatilkynning verkefnisstjóra

6.8.2021

Markmið rannsóknarinnar var að meta áhrif
skimunar fyrir MGUS á lífslíkur og til að fá vísindalega sönnun fyrir bestri leið til eftirfylgni. Við
nýttum okkur það að flestir einstaklingar >40 ára fara í blóðprufu af ýmsum ástæðum en þeim
sem ekki komu af öðrum ástæðum var boðið að koma sérstaklega til að gefa sýni. Við
framkvæmum próteinrafdrátt og mælingar á léttum keðjum á öllum þátttakendum.
Einstaklingar með MGUS verður svo boðin þátttaka í slembdri klínískri prófun með markmiðið
að greina bestu leið til uppvinnslu og eftirfylgni. Rannsókn okkar er sú stærsta sinnar
tegundar í heiminum og mun svara fjölda mikilvægra læknisfræðilegra og vísindalegra
spurninga og vonandi á endanum leiða til þessa að lækning finnist við mergæxli.

English:
Monoclonal gammopathy of undetermined significance (MGUS) is a very common precursor
condition to multiple myeloma (MM), and related diseases, and can be found in
approximately 4% of individuals over the age of 50 years. MM is always preceded by MGUS,
however most patients will never progress. In this project we invited all Icelanders over the
age of 40 to participate in a nationwide screening study named Iceland Screens Treats or
Prevents Multiple Myeloma (iStopMM) or “Blóðskimun til bjargar, þjóðarátak gegn mergæxli”
in Icelandic. Of those 80,759 (54.3%) provided informed consent for screening and over
75,000 blood samples were obtained. The aim of the project was to evaluate the effect of
screening for MGUS on survival and to provide a scientific evidence for optimal follow-up
strategies. This was mostly done by utilizing already present infrastructure for screening in
Iceland and the fact that most individuals > 40 years have their blood drawn for various
reasons over a period of 3 years. Those that do not have blood drawn or other reasons were
contacted invited to come to the study clinic or primary health care center to provide a
sample. We performed serum electrophoresis (SPEP) and free light chain analyses in all the
participants to diagnose MGUS. Participants who have MGUS enter a randomized controlled
trial aimed at evaluating the work-up and follow-up strategy. The resulting large, unique,
population-based study has been a major success in its execution and is poised to have very
important clinical and scientific implications as results are analyzed and published.

References
1 Rögnvaldsson, S., Löve, Þ., Thorsteinsdottir, S., Reed, E., Óskarsson, J., Pétursdóttir, Í.,
Sigurðardóttir, G., Viðarsson, B., Önundarson, P., Agnarsson, B., Sigurðardóttir, M.,
Þorsteinsdóttir, I., Ólafsson, Í., Þórðardóttir, Á., Eyþórsson, E., Jónsson, Á., Björnsson, A.,
Gunnarsson, G., Pálsson, R., Indriðason, Ó., Gíslason, G., Andri, Ó., Hákonardóttir, G.,
Brinkhuis, M., Halldórsdóttir, S., Ásgeirsdóttir, T., Steingrímsdóttir, H., Danielsen, R.,
Wessman, I., Kampanis, P., Hlutcranz, M., Durie, B., Harding, S., Landgren, O. & Kristinsson, S.
Y. Iceland Screens, Treats, or Prevents Multiple Myeloma (iStopMM): A population-based
screening study for monoclonal gammopathy of undetermined significance and randomized
controlled trial of follow-up strategies. Blood cancer journal (2021 In press.).

2 Sverrisdóttir, I. S., Rögnvaldsson, S., Thorsteinsdottir, S., Gíslason, G. K., Aspelund, T.,
Turesson, I., Björkholm, M., Gregersen, H., Hveding Blimark, C., Landgren, O. & Kristinsson, S.
Y. Comorbidities in multiple myeloma and implications on survival: A population-based study.
Eur J Haematol (2021).

3 Baldursdóttir, T. R., Löve Þ, J., Gíslason, G. K., Björkholm, M., Mellqvist, U. H., Lund, S. H.,
Blimark, C. H., Turesson, I., Hultcrantz, M., Landgren, O. & Kristinsson, S. Y. Autoimmune
disease is associated with a lower risk of progression in monoclonal gammopathy of
undetermined significance. Eur J Haematol 106, 380-388 (2021).

4 Thorsteinsdottir, S., Gislason, G., Aspelund, T., Sverrisdottir, I., Landgren, O., Turesson, I.,
Björkholm, M. & Kristinsson, S. Y. Fractures and survival in multiple myeloma: results from a
population-based study. Haematologica 105, 1067-1073 (2020).

5 Sverrisdóttir, I. S., Lund, S. H., Turesson, I., Björkholm, M., Goldin, L. R., Landgren, O. &
Kristinsson, S. Y. Parental longevity and survival among patients with multiple myeloma and
monoclonal gammopathy of undetermined significance: a population-based study. Br J
Haematol 186, 37-44 (2019).

6 Thorsteinsdottir, S., Dickman, P. W., Landgren, O., Blimark, C., Hultcrantz, M., Turesson, I.,
Björkholm, M. & Kristinsson, S. Y. Dramatically improved survival in multiple myeloma
patients in the recent decade: results from a Swedish population-based study.
Haematologica 103, e412-e415 (2018).

7 Thordardottir, M., Lindqvist, E. K., Lund, S. H., Costello, R., Burton, D., Steingrimsdottir, L.,
Korde, N., Mailankody, S., Eiriksdottir, G., Launer, L. J., Gudnason, V., Harris, T. B., Landgren,
O., Torfadottir, J. E. & Kristinsson, S. Y. Dietary intake is associated with risk of multiple
myeloma and its precursor disease. PLoS One 13, e0206047 (2018).

8 Thorsteinsdottir, S., Lund, S. H., Lindqvist, E. K., Thordardottir, M., Sigurdsson, G., Costello, R.,
Burton, D., Steingrimsdottir, H., Gudnason, V., Eiriksdottir, G., Siggeirsdottir, K., Harris, T. B.,
Landgren, O. & Kristinsson, S. Y. Bone disease in monoclonal gammopathy of undetermined
significance: results from a screened population-based study. Blood Adv 1, 2790-2798 (2017).

Heiti verkefnis: Þjóðarátak gegn krabbameinum - Blóðskimun til bjargar/ Iceland Screens Treats or Prevents Multiple Myeloma (iStopMM)
Verkefnisstjóri: Sigurður Yngvi Kristinsson, Háskóla Íslands
Tegund styrks: Öndvegisstyrkur
Styrktímabil: 2017-2019
Fjárhæð styrks: 138,294 millj. kr. alls
Tilvísunarnúmer Rannís: 173857