Berger Tamar, Shacham Abulafia Adi, Shimony Shai, Pasvolsky Oren, Vaxman Iuliana, Miron Yifat, Feldman Shimrit, Leader Avi, Raanani Pia
Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Acta Haematol. 2022;145(6):619-626. doi: 10.1159/000526168. Epub 2022 Jul 29.
Data regarding the prevalence of paraproteinemia in patients with chronic myeloid leukemia (CML) are lacking.
To evaluate for the prevalence of paraproteinemia, we undertook this cross-sectional study among consecutive chronic-phase CML patients. Complete blood count, chemistry, immunoglobulins, serum-free light chains, serum-protein electrophoresis and immunofixation were collected. Further analyses evaluated whether various patient-, disease-, and treatment-related variables are associated with paraproteinemia.
One hundred patients, median age 63.5 (IQR 48.1-72) years were recruited. Median time from CML diagnosis to enrollment was 6.3 (IQR 2.3-11.3) years. Monoclonal protein was detected in 8 patients (8%), diagnosed with smoldering multiple myeloma (SMM, n = 2) and low-risk monoclonal gammopathy of undetermined significance (MGUS, n = 6). Six patients were on tyrosine kinase inhibitor treatment, 2 were in treatment-free remission. The only covariate associated with paraproteinemia was the presence of anemia, albeit with borderline statistical significance in univariate analysis (p = 0.053) and when adjusted for age (p = 0.056).
In this largest study so far describing the prevalence of paraproteinemia among CML patients, we found MGUS prevalence to be higher than the 3.2% expected prevalence in the general population above 50 years and a non-negligible prevalence of SMM (2%). Screening for paraproteinemia in CML patients, especially in the presence of anemia, should be considered.
关于慢性髓系白血病（CML）患者副蛋白血症患病率的数据尚缺。
为评估副蛋白血症的患病率，我们对连续性慢性期CML患者进行了这项横断面研究。收集了全血细胞计数、生化指标、免疫球蛋白、血清游离轻链、血清蛋白电泳和免疫固定电泳结果。进一步分析评估了各种与患者、疾病和治疗相关的变量是否与副蛋白血症有关。
招募了100例患者，中位年龄63.5（四分位间距48.1 - 72）岁。从CML诊断到入组的中位时间为6.3（四分位间距2.3 - 11.3）年。在8例患者（8%）中检测到单克隆蛋白，诊断为冒烟型多发性骨髓瘤（SMM，n = 2）和意义未明的低风险单克隆丙种球蛋白病（MGUS，n = 6）。6例患者接受酪氨酸激酶抑制剂治疗，2例处于无治疗缓解期。与副蛋白血症相关的唯一协变量是贫血的存在，尽管在单因素分析中具有临界统计学意义（p = 0.053），在调整年龄后（p = 0.056）也是如此。
在这项迄今为止描述CML患者中副蛋白血症患病率的最大规模研究中，我们发现MGUS患病率高于50岁以上普通人群预期的3.2%患病率，且SMM患病率不可忽略（2%）。应考虑对CML患者进行副蛋白血症筛查，尤其是在存在贫血的情况下。
