Fifty-Year Incidence of Waldenström Macroglobulinemia in Olmsted County, Minnesota, From 1961 Through 2010: A Population-Based Study With Complete Case Capture and Hematopathologic Review

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Abstract

Objective: To determine the incidence of Waldenström macroglobulinemia (WM) in a strictly defined geographic area over a 50-year period. Patients and Methods: All residents of Olmsted County with a diagnosis of WM, consisting of a monoclonal IgM protein of any size and/or 10% or more lymphoplasmacytic infiltration of the bone marrow along with anemia, constitutional symptoms, hyperviscosity, lymphadenopathy, or hepatosplenomegaly requiring therapy, were identified from January 1, 1961, to December 31, 2010. Patients with smoldering WM, lymphoplasmacytic lymphoma with an IgG or IgA monoclonal protein, and those with an IgM monoclonal gammopathy of undetermined significance were excluded. The peripheral blood smears, bone marrow aspirates, and biopsy specimens were reviewed by an experienced hematopathologist. Results: Twenty-two patients were identified as having WM. The age-adjusted incidence rate for males was 0.92 per 100,000 person-years (95% CI, 0.44-1.39 per 100,000 person-years) and for females was 0.30 per 100,000 person-years (95% CI, 0.08-0.53 per 100,000 person-years) with an age- and sex-adjusted incidence of 0.57 per 100,000 person-years (95% CI, 0.33-0.81 per 100,000 person-years). When evaluated using a smoothing spline, there was no convincing evidence for a change in the incidence of WM over the past 50 years. Patients diagnosed with WM after 2000 had an approximately 2-fold excess mortality compared with the expected population mortality (standardized mortality ratio, 2.4; 95% CI, 0.64-6.0). Conclusion: Waldenström macroglobulinemia is a rare malignancy, and the incidence in Olmsted County, Minnesota, has shown virtually no change over the past 50 years.

Original languageEnglish (US)
JournalMayo Clinic Proceedings
DOIs
StateAccepted/In press - Jan 1 2018

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Waldenstrom Macroglobulinemia
Incidence
Population
Immunoglobulin M
Mortality
Bone Marrow
Monoclonal Gammopathy of Undetermined Significance
Immunoglobulin A
Anemia
Lymphoma
Proteins
Immunoglobulin G
Biopsy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{9042b32d8d89468fb4c392fc33eafb5d,
title = "Fifty-Year Incidence of Waldenstr{\"o}m Macroglobulinemia in Olmsted County, Minnesota, From 1961 Through 2010: A Population-Based Study With Complete Case Capture and Hematopathologic Review",
abstract = "Objective: To determine the incidence of Waldenstr{\"o}m macroglobulinemia (WM) in a strictly defined geographic area over a 50-year period. Patients and Methods: All residents of Olmsted County with a diagnosis of WM, consisting of a monoclonal IgM protein of any size and/or 10{\%} or more lymphoplasmacytic infiltration of the bone marrow along with anemia, constitutional symptoms, hyperviscosity, lymphadenopathy, or hepatosplenomegaly requiring therapy, were identified from January 1, 1961, to December 31, 2010. Patients with smoldering WM, lymphoplasmacytic lymphoma with an IgG or IgA monoclonal protein, and those with an IgM monoclonal gammopathy of undetermined significance were excluded. The peripheral blood smears, bone marrow aspirates, and biopsy specimens were reviewed by an experienced hematopathologist. Results: Twenty-two patients were identified as having WM. The age-adjusted incidence rate for males was 0.92 per 100,000 person-years (95{\%} CI, 0.44-1.39 per 100,000 person-years) and for females was 0.30 per 100,000 person-years (95{\%} CI, 0.08-0.53 per 100,000 person-years) with an age- and sex-adjusted incidence of 0.57 per 100,000 person-years (95{\%} CI, 0.33-0.81 per 100,000 person-years). When evaluated using a smoothing spline, there was no convincing evidence for a change in the incidence of WM over the past 50 years. Patients diagnosed with WM after 2000 had an approximately 2-fold excess mortality compared with the expected population mortality (standardized mortality ratio, 2.4; 95{\%} CI, 0.64-6.0). Conclusion: Waldenstr{\"o}m macroglobulinemia is a rare malignancy, and the incidence in Olmsted County, Minnesota, has shown virtually no change over the past 50 years.",
author = "Kyle, {Robert A.} and Larson, {Dirk R.} and Ellen McPhail and Therneau, {Terry M} and Angela Dispenzieri and Kumar, {Shaji K} and Prashant Kapoor and Cerhan, {James R} and Rajkumar, {S Vincent}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.mayocp.2018.02.011",
language = "English (US)",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",

}

TY - JOUR

T1 - Fifty-Year Incidence of Waldenström Macroglobulinemia in Olmsted County, Minnesota, From 1961 Through 2010

T2 - A Population-Based Study With Complete Case Capture and Hematopathologic Review

AU - Kyle, Robert A.

AU - Larson, Dirk R.

AU - McPhail, Ellen

AU - Therneau, Terry M

AU - Dispenzieri, Angela

AU - Kumar, Shaji K

AU - Kapoor, Prashant

AU - Cerhan, James R

AU - Rajkumar, S Vincent

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: To determine the incidence of Waldenström macroglobulinemia (WM) in a strictly defined geographic area over a 50-year period. Patients and Methods: All residents of Olmsted County with a diagnosis of WM, consisting of a monoclonal IgM protein of any size and/or 10% or more lymphoplasmacytic infiltration of the bone marrow along with anemia, constitutional symptoms, hyperviscosity, lymphadenopathy, or hepatosplenomegaly requiring therapy, were identified from January 1, 1961, to December 31, 2010. Patients with smoldering WM, lymphoplasmacytic lymphoma with an IgG or IgA monoclonal protein, and those with an IgM monoclonal gammopathy of undetermined significance were excluded. The peripheral blood smears, bone marrow aspirates, and biopsy specimens were reviewed by an experienced hematopathologist. Results: Twenty-two patients were identified as having WM. The age-adjusted incidence rate for males was 0.92 per 100,000 person-years (95% CI, 0.44-1.39 per 100,000 person-years) and for females was 0.30 per 100,000 person-years (95% CI, 0.08-0.53 per 100,000 person-years) with an age- and sex-adjusted incidence of 0.57 per 100,000 person-years (95% CI, 0.33-0.81 per 100,000 person-years). When evaluated using a smoothing spline, there was no convincing evidence for a change in the incidence of WM over the past 50 years. Patients diagnosed with WM after 2000 had an approximately 2-fold excess mortality compared with the expected population mortality (standardized mortality ratio, 2.4; 95% CI, 0.64-6.0). Conclusion: Waldenström macroglobulinemia is a rare malignancy, and the incidence in Olmsted County, Minnesota, has shown virtually no change over the past 50 years.

AB - Objective: To determine the incidence of Waldenström macroglobulinemia (WM) in a strictly defined geographic area over a 50-year period. Patients and Methods: All residents of Olmsted County with a diagnosis of WM, consisting of a monoclonal IgM protein of any size and/or 10% or more lymphoplasmacytic infiltration of the bone marrow along with anemia, constitutional symptoms, hyperviscosity, lymphadenopathy, or hepatosplenomegaly requiring therapy, were identified from January 1, 1961, to December 31, 2010. Patients with smoldering WM, lymphoplasmacytic lymphoma with an IgG or IgA monoclonal protein, and those with an IgM monoclonal gammopathy of undetermined significance were excluded. The peripheral blood smears, bone marrow aspirates, and biopsy specimens were reviewed by an experienced hematopathologist. Results: Twenty-two patients were identified as having WM. The age-adjusted incidence rate for males was 0.92 per 100,000 person-years (95% CI, 0.44-1.39 per 100,000 person-years) and for females was 0.30 per 100,000 person-years (95% CI, 0.08-0.53 per 100,000 person-years) with an age- and sex-adjusted incidence of 0.57 per 100,000 person-years (95% CI, 0.33-0.81 per 100,000 person-years). When evaluated using a smoothing spline, there was no convincing evidence for a change in the incidence of WM over the past 50 years. Patients diagnosed with WM after 2000 had an approximately 2-fold excess mortality compared with the expected population mortality (standardized mortality ratio, 2.4; 95% CI, 0.64-6.0). Conclusion: Waldenström macroglobulinemia is a rare malignancy, and the incidence in Olmsted County, Minnesota, has shown virtually no change over the past 50 years.

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U2 - 10.1016/j.mayocp.2018.02.011

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