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

Robert A. Kyle, Terry M Therneau, S Vincent Rajkumar, Ellen McPhail, Janice R. Offord, Dirk R. Larson, Matthew F. Plevak, L. Joseph Melton

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)3759-3764
Number of pages6
JournalBlood
Volume102
Issue number10
DOIs
StatePublished - Nov 15 2003

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Monoclonal Gammopathy of Undetermined Significance
Immunoglobulin M
Lymphoma
Waldenstrom Macroglobulinemia
Population Surveillance
SEER Program
Immunoglobulin Isotypes
Epidemiology
B-Cell Chronic Lymphocytic Leukemia
Plasma Cells
Multiple Myeloma
Serum Albumin
Immunoglobulin A
Blood Proteins
Multivariate Analysis
Immunoglobulin G
Proteins
Plasmas
Incidence

ASJC Scopus subject areas

  • Hematology

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Long-term follow-up of IgM monoclonal gammopathy of undetermined significance. / Kyle, Robert A.; Therneau, Terry M; Rajkumar, S Vincent; McPhail, Ellen; Offord, Janice R.; Larson, Dirk R.; Plevak, Matthew F.; Melton, L. Joseph.

In: Blood, Vol. 102, No. 10, 15.11.2003, p. 3759-3764.

Research output: Contribution to journalArticle

Kyle, Robert A. ; Therneau, Terry M ; Rajkumar, S Vincent ; McPhail, Ellen ; Offord, Janice R. ; Larson, Dirk R. ; Plevak, Matthew F. ; Melton, L. Joseph. / Long-term follow-up of IgM monoclonal gammopathy of undetermined significance. In: Blood. 2003 ; Vol. 102, No. 10. pp. 3759-3764.
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