Anagnostopoulos A, Evangelopoulou A, Sotou D, Gika D, Mitsibounas D, Dimopoulos M-A
The University of Texas M.D. Anderson Cancer Center, Box 423, 1515 Holcombe Boulevard, Houston 77030-4009, USA.
Ann Hematol. 2002 Jul;81(7):357-61. doi: 10.1007/s00277-002-0493-0. Epub 2002 Jul 11.
Monoclonal gammopathy of undetermined significance (MGUS) is a relatively common condition among individuals older than 70 years. The actuarial risk of MGUS progression to an overt plasma cell malignancy (PCM) after 20 years of follow-up has been reported to be as high as 30%. The purpose of this study was to evaluate the incidence and evolution of MGUS in a Greek population: 1564 consecutive patients older than 50 years who were admitted to the Department of Clinical Therapeutics at the University of Athens School of Medicine for various reasons over a 26-month period were evaluated with serum protein electrophoresis. In cases in which a monoclonal protein was detected, a panel of tests was performed to rule out an underlying plasma cell malignancy (PCM). Serum levels of interleukin (IL)-6, IL-6-soluble receptor (IL-6SR), IL-1 beta, and transforming growth factor beta 1 were also measured in the MGUS cases. Patients with MGUS were monitored at regular intervals for evidence of multiple myeloma or other PCMs. The incidence of MGUS was 4% and there was a positive correlation with increasing age. The median value of serum M peak was only 5.3 g/l. After a median follow-up of 71 months, only two patients developed multiple myeloma (60 and 75 months after initial diagnosis). Our data are consistent with those of other epidemiological studies regarding the incidence of MGUS, but the monoclonal protein levels and the probability of evolution to a malignant plasma cell disorder appeared to be lower in our study than in other series. Our data support the hypothesis that individuals with low M peak values require only regular annual follow-up examinations.
意义未明的单克隆丙种球蛋白病（MGUS）在70岁以上人群中较为常见。据报道，MGUS经过20年随访进展为明显浆细胞恶性肿瘤（PCM）的精算风险高达30%。本研究的目的是评估希腊人群中MGUS的发病率和演变情况：在26个月期间，对因各种原因入住雅典大学医学院临床治疗学系的1564例年龄超过50岁的连续患者进行血清蛋白电泳评估。在检测到单克隆蛋白的病例中，进行了一系列检查以排除潜在的浆细胞恶性肿瘤（PCM）。还测量了MGUS病例中白细胞介素（IL）-6、IL-6可溶性受体（IL-6SR）、IL-1β和转化生长因子β1的血清水平。对MGUS患者定期进行监测，以寻找多发性骨髓瘤或其他PCM的证据。MGUS的发病率为4%，且与年龄增长呈正相关。血清M峰的中位数仅为5.3g/l。中位随访71个月后，仅有2例患者发展为多发性骨髓瘤（初始诊断后60和75个月）。我们的数据与其他关于MGUS发病率的流行病学研究数据一致，但我们研究中的单克隆蛋白水平以及演变为恶性浆细胞疾病的可能性似乎低于其他系列研究。我们的数据支持这样的假设，即M峰低值的个体仅需每年定期进行随访检查。
