Department of Medicine, Mayo Medical School, Rochester, MN, USA.
Blood. 2011 Sep 15;118(11):2985-7. doi: 10.1182/blood-2011-04-349175. Epub 2011 Jul 15.
During the course of multiple myeloma (MM), new monoclonal proteins of an isotype distinct from the original clone, referred to as secondary monoclonal gammopathy of undetermined significance (MGUS), have been described. We report on the frequency, characteristics, and outcome of secondary MGUS. Of the 1942 patients with MM, 128 (6.6%) developed a secondary MGUS, at a median of 12 months from the diagnosis of MM. The median duration of secondary MGUS was 5.9 months. Secondary MGUS was more common in patients after stem cell transplantation than in those who had not undergone such treatment (22.7% vs 1.6%, P < .001). Overall survival was significantly superior in MM patients who developed secondary MGUS compared with the rest of the cohort (73 vs 38 months, respectively; P < .001). The time of onset and the duration of secondary MGUS, as well as failure to resolve spontaneously, had an effect on overall survival and require further study.
在多发性骨髓瘤（MM）的病程中，已经描述了与原始克隆不同的同种型的新单克隆蛋白，称为次要意义未明的单克隆丙种球蛋白血症（MGUS）。我们报告了次要 MGUS 的频率、特征和结果。在 1942 例 MM 患者中，有 128 例（6.6%）在 MM 诊断后 12 个月时发生了次要 MGUS。次要 MGUS 的中位持续时间为 5.9 个月。与未接受干细胞移植治疗的患者相比，接受干细胞移植治疗的患者发生次要 MGUS 的比例更高（22.7%对 1.6%，P<0.001）。与队列中的其余患者相比，发生次要 MGUS 的 MM 患者的总生存率显著提高（分别为 73 个月和 38 个月，P<0.001）。次要 MGUS 的发病时间、持续时间以及无法自发消退均对总生存率有影响，需要进一步研究。
