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Monoclonal gammopathies of undetermined significance: a review
Author(s) -
Kyle Robert A.,
Rajkumar S. Vincent
Publication year - 2003
Publication title -
immunological reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.839
H-Index - 223
eISSN - 1600-065X
pISSN - 0105-2896
DOI - 10.1034/j.1600-065x.2003.00056.x
Subject(s) - monoclonal gammopathy of undetermined significance , macroglobulinemia , multiple myeloma , waldenstrom macroglobulinemia , medicine , gammopathy , myeloma protein , lymphoproliferative disorders , monoclonal , amyloidosis , immunology , immunoglobulin m , pathology , gastroenterology , monoclonal antibody , antibody , immunoglobulin g , lymphoma
Summary: Monoclonal gammopathy of undetermined significance (MGUS) denotes the presence of a monoclonal protein (M‐protein) in patients without evidence of multiple myeloma (MM), macroglobulinemia, amyloidosis (AL), or a related plasma cell proliferative disorder. MGUS is found in approximately 3% of persons older than 70 years and in about 1% of those older than 50 years. In a series of 1384 patients from south‐eastern Minnesota in whom MGUS was diagnosed at Mayo Clinic from 1960 through 1994, the risk of progression was 1% per year. Patients were at risk of progression even after 25 years or more of a stable monoclonal gammopathy. The risk of development of MM was increased by 25‐fold, the risk of macroglobulinemia was 46‐fold, and the risk of primary AL was 8.4‐fold when compared with a similar population (Surveillance, Epidemiology and End Results). The concentration of the serum M‐protein was the major independent predictor of progression. Patients with an immunoglobulin M (IgM) or an IgA monoclonal gammopathy had a higher risk of progression than those with an IgG monoclonal gammopathy. The presence of a urine M‐protein or the reduction of one or more uninvolved Igs was not a risk factor for progression. MGUS may be associated with many different disorders, including lymphoproliferative diseases, leukemia, connective tissue disorders, dermatologic diseases, and neurologic disorders.