Integrative Multi-omics Analysis to Predict Monoclonal Gammopathies Clinical Evolution
This prospective, multicenter, observational study aims to identify molecular and immunological markers associated with disease progression in patients with monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). By integrating genomic, transcriptomic, immunophenotypic, and oral microbiome analyses, the study seeks to characterize the biological mechanisms underlying the transition to symptomatic multiple myeloma (MM). The study also includes in vitro modeling to investigate bone damage and immune dysfunction. Healthy volunteers (HV) undergoing joint replacement surgery for osteoarthritis will serve as controls. The ultimate goal is to improve early risk stratification and support future preventive strategies through a multi-omics approach. There is a pressing need for new strategies to identify high-risk individuals based on biological rather than purely clinical parameters. This study proposes an integrative, multi-omics approach to investigate the transition from MGUS/SMM to MM. By analyzing the immunome and oral microbiome alongside molecular profiling, the goal is to identify reliable biomarkers of progression. The resulting insights could be enable more accurate risk stratification and guide the design of future preventive clinical trials aimed at delaying or halting disease evolution.
• Age \>18 years
• Male or female patients
• Histologically confirmed diagnosis of MGUS, SMM, or MM according to ESMO 2021 guidelines
• Willing and able to provide written informed consent
⁃ HEALTHY VOLUNTEERS (HV)
• Age \>60 years
• Diagnosis of osteoarthritis (OA)
• Scheduled for hospitalization for surgical treatment of OA (endoprosthesis or arthroplasty)
• Willing and able to provide written informed consent