Long-term follow-up of IgM monoclonal gammopathy of undetermined significance.

Blood 2003 Nov 24;102(10):3759-64. Epub 2003 Jul 24.

Division of Hematology and Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.

Little effort has been made to quantitate adverse outcomes of monoclonal gammopathy of undetermined significance (MGUS) of the immunoglobulin M (IgM) class, which progresses to lymphoma or Waldenström macroglobulinemia, whereas IgA and IgG MGUS progress to multiple myeloma, primary amyloidosis (AL), or a related plasma cell disorder. From 1960 to 1994, IgM MGUS was diagnosed in 213 patients in southeastern Minnesota. The end point was progression to lymphoma or a related disorder, as assessed with the Kaplan-Meier method. The 213 patients were followed up for 1567 person-years (median, 6.3 years per patient). Lymphoma developed in 17 patients (relative risk [RR], 14.8), Waldenström macroglobulinemia in 6 (RR, 262), primary amyloidosis in 3 (RR, 16.3), and chronic lymphocytic leukemia in 3 (RR, 5.7). The relative risk of progression was 16-fold higher in the patients with IgM MGUS than in the white population of the Iowa Surveillance, Epidemiology, and End Results Program. Cumulative incidence of progression was 10% at 5 years, 18% at 10 years, and 24% at 15 years. On multivariate analysis, the serum monoclonal protein and serum albumin concentrations at diagnosis were the only risk factors for progression to lymphoma or a related disorder. Risk for progression to lymphoma or a related disorder at 10 years after the diagnosis of MGUS was 14% with an initial monoclonal protein concentration of 0.5 g/dL or less, 26% with 1.5 g/dL, 34% for 2.0 g/dL, and 41% for more than 2.5 g/dL.

Download full-text PDF

Source
http://dx.doi.org/10.1182/blood-2003-03-0801DOI Listing
November 2003
2 Reads

Publication Analysis

Top Keywords

lymphoma disorder
12
progression lymphoma
12
igm mgus
8
undetermined significance
8
monoclonal protein
8
risk progression
8
gammopathy undetermined
8
primary amyloidosis
8
waldenström macroglobulinemia
8
relative risk
8
monoclonal gammopathy
8
213 patients
8
progression
5
years
5
mgus
5
lymphoma
5
albumin concentrations
4
patients relative
4
years patient
4
developed patients
4

References

(Supplied by CrossRef)

Similar Publications