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意义未明的单克隆丙种球蛋白血症(MGUS)的流行病学:来自法国下诺曼底地区血液系统恶性肿瘤专科登记处的经验。

Epidemiology of Monoclonal Gammopathy of Undetermined Significance (MGUS): The experience from the specialized registry of hematologic malignancies of Basse-Normandie (France).

机构信息

Service d'Hématologie Clinique, CHU de Caen, 14000 Caen, France.

Service d'Hématologie Clinique, CHU de Caen, 14000 Caen, France.

出版信息

Cancer Epidemiol. 2014 Aug;38(4):354-6. doi: 10.1016/j.canep.2014.04.006. Epub 2014 May 29.

Abstract

Multiple myeloma (MM) is the third most common haematologic malignancy in European countries, and is usually preceded by Monoclonal Gammopathy of Undetermined Significance (MGUS). Therefore epidemiologic studies of MGUS are very limited in a population-based status. Here we report all new cases of MGUS exhaustively recorded by the Basse-Normandie Regional Registry for Hematologic Malignancies (a French region registry) between January 1997 and December 2005, and analyze outcome of patients until 2009 in term of evolution in MM or death. All cases were analyzed by an expert file review, and MGUS diagnosis was retained for: evidence of a monoclonal component <30 g/l and no CRAB criteria (hyperCalcemia, renal insufficiency, anemia, bone lesions). We showed that the world standardized incidence rate (WSR) for MGUS was 3.76 ± 0.26 per 100,000 inhabitants, increasing regularly with age, and that the median overall survival (OS) was 115.9 months (CI 95%: 10.5-130.2 months) with 78.3% patients alive at 5 years (CI 95%: 74.1-81.9%). We also observed a rate of progression to multiple myeloma of 1.41% per year, concordant with previous reports in a reallife exhaustive registry.

摘要

多发性骨髓瘤(MM)是欧洲国家中第三常见的血液系统恶性肿瘤,通常以前有意义未明的单克隆丙种球蛋白血症(MGUS)。因此,在基于人群的状态下,MGUS 的流行病学研究非常有限。在这里,我们报告了巴塞诺曼第地区血液系统恶性肿瘤登记处(法国地区登记处)在 1997 年 1 月至 2005 年 12 月期间详尽记录的所有新的 MGUS 病例,并分析了截至 2009 年患者的结局,即 MM 进展或死亡。所有病例均通过专家文件审查进行分析,MGUS 诊断保留为:单克隆成分<30 g/l,且无 CRAB 标准(高钙血症、肾功能不全、贫血、骨病变)。我们表明,MGUS 的世界标准化发病比(WSR)为 3.76±0.26/10 万人,随年龄增长而规律增加,总生存(OS)中位数为 115.9 个月(95%CI:10.5-130.2 个月),5 年时 78.3%的患者存活(95%CI:74.1-81.9%)。我们还观察到每年向多发性骨髓瘤进展的比例为 1.41%,与真实世界详尽登记处的先前报告一致。

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