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, Waldenström's macroglobulinaemia 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 unselected 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<0.01).
Likewise, an initial high gamma globulin level was also found to be a risk factor (18.7g/l v 13.7g/l in the control group, P<0.01).
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.
Mots-clés Pascal : Immunoglobulinémie monoclonale bénigne, Facteur risque, Transformation maligne, Myélome, Incidence, Epidémiologie, Lymphome non hodgkinien, Pays Bas, Europe, Sud, Macroglobulinémie Waldenström, Ambulatoire, Hôpital, Homme, Hémopathie maligne, Lymphoprolifératif syndrome, Immunopathologie, Immunoglobulinopathie, Etude cas témoin
Mots-clés Pascal anglais : Benign monoclonal immunoglobulinemia, Risk factor, Malignant transformation, Myeloma, Incidence, Epidemiology, Non Hodgkin lymphoma, Netherlands, Europe, South, Waldenstrom macroglobulinemia, Ambulatory, Hospital, Human, Malignant hemopathy, Lymphoproliferative syndrome, Immunopathology, Immunoglobulinopathy, Case control study
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0531777
Code Inist : 002B06D02. Création : 01/03/1996.