Giraldo M P, Rubio-Félix D, Perella M, Gracía J A, Bergua J M, Giralt M
Servicio Regional de Hematología y Hemoterapia, Hospital Miguel Servet.
Sangre (Barc). 1991 Oct;36(5):377-82.
The diagnostic criteria, incidence, clinical characteristics and outcome of 397 patients with monoclonal gammopathies of undetermined significance, all of them diagnosed and followed-up at the Haematology Service of the Miguel Servet Hospital, in Zaragoza, between January 1970 and December 1988, were revised. The patients' mean age was 64.7 years (range: 2-89). The M/F ratio was 236/161. The mean concentration of the M component (MC) was 1.17 g/dL (range: 0.20-3.50), this being under 0.50 in 65 cases. IgG was the most frequent MC (71.26%), followed by IgA (14.34%) and IgM (10.82%). Multiple MC was present in 14 cases (3.58). Light chains were passed in urine by 33 patients (8.31%). No associated pathology was found in 213 patients (53.65%) upon MC discovery, while 65 other (16.31%) were carriers of different blood disorders, chronic lymphoproliferative diseases being the commonest (11.57%). In 30 patients (7.30%) the MC was associated to nonhaematological malignancies, and 29 others had an underlying chronic infection. Chronic liver disease was present in 25 cases, and autoimmune disease in 14. Transient monoclonal gammopathy was seen in a small group of patients (6.54%), most of them suffering from acute infectious illness. With regard to the group of patients without any associated pathology, their median follow-up was 37.8 months (range: 18-228). Of them, the MC kept unchanged in 134 cases (62.91%); 47(22.06%) died from any unrelated cause, and 10 others evolved into malignant monoclonal gammopathy. The median clinical course of these last expanded to 60 months (range: 11-124), with an accumulated actuarial risk of 4.5% at 5 years, 15% at 10 years and 26% at 15 years.
对1970年1月至1988年12月期间在萨拉戈萨米格尔·塞尔维特医院血液科确诊并随访的397例意义未明的单克隆丙种球蛋白病患者的诊断标准、发病率、临床特征及转归进行了回顾。患者的平均年龄为64.7岁（范围：2至89岁）。男女比例为236/161。M成分（MC）的平均浓度为1.17 g/dL（范围：0.20至3.50），65例患者的MC浓度低于0.50。IgG是最常见的MC（71.26%），其次是IgA（14.34%）和IgM（10.82%）。14例患者（3.58%）存在多种MC。33例患者（8.31%）尿中出现轻链。发现MC时，213例患者（53.65%）未发现相关病变，另外65例（16.31%）患有不同的血液疾病，最常见的是慢性淋巴细胞增殖性疾病（11.57%）。30例患者（7.30%）的MC与非血液系统恶性肿瘤相关联，另外29例有潜在的慢性感染。25例患者存在慢性肝病，14例有自身免疫性疾病。一小部分患者（6.54%）出现短暂性单克隆丙种球蛋白病，其中大多数患有急性感染性疾病。对于无任何相关病变的患者组，他们的中位随访时间为37.8个月（范围：18至228个月）。其中，134例患者（62.91%）的MC保持不变；47例（22.06%）死于任何无关原因，另外10例进展为恶性单克隆丙种球蛋白病。最后这组患者的中位病程延长至60个月（范围：11至124个月），5年累积精算风险为4.5%，10年为15%（此处原英文有误，根据语境推测为15%），15年为26%。
