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Malignant transformation of monoclonal gammopathy of undetermined significance among out‐patients of a community hospital in Southeastern Netherlands
Author(s) -
Poel M. H. W.,
Coebergh J. W. W.,
Hillen H. F. P.
Publication year - 1995
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1995.tb05256.x
Subject(s) - monoclonal gammopathy of undetermined significance , monoclonal gammopathy , medicine , monoclonal , immunology , monoclonal antibody , antibody
Summary Patients with a monoclonal gammopathy without evidence of lymphoproliferative or plasma cell malignancy within a year are still at risk for malignant transformation to multiple myeloma, Waldenstrom's macro‐globulinaemia or non‐Hodgkin's lymphoma. In a prospective study performed at the Mayo Clinic, the cumulative incidence of malignant transformation was 29% in 14 years. We conducted a retrospective study to determine the frequency of malignant transformation among 334 un‐selected out‐patients with monoclonal gammopathy of undetermined significance (MGUS) from a community hospital in Southeastern Netherlands. The cumulative incidence of malignant transformation was 11% in 14 years (95% confidence interval 6–17%). The long‐term survival of patients with MGUS was slightly lower than that of the average regional population. In a nested case‐control study, presence of a kappa light chain was found to be a risk factor for malignant transformation (70% of patients who developed malignant transformation compared to 30% of the control group, P < 001). Likewise, an initial high gamma globulin level was also found to be a risk factor (18–7g/1 v 13–7g/l in the control group, P<001). As neither risk factor has been described before, the significance of these factors for definition of a high‐risk group among patients with monoclonal gammopathy remains to be determined.