Faculty of Medicine and Pharmacy, The Military Hospital Instruction Mohamed V/Mohamed V University, Rabat, Morocco.
Clinical Chemistry Department, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir Teaching Hospital, Agadir, Morocco.
Cancer Rep (Hoboken). 2023 May;6(5):e1814. doi: 10.1002/cnr2.1814. Epub 2023 Mar 31.
Monoclonal gammopathies are a group of disorders associated with clonal proliferation of plasma cells that produces a monoclonal protein.
The main objective of this study was to describe the epidemiological and immunochemical characteristics of monoclonal gammopathies diagnosed during 19 years in a Moroccan teaching hospital.
This retrospective study enrolled 443 Moroccan patients with monoclonal gammopathy, patients meeting the inclusion and exclusion criteria in at the biochemistry department of Military Hospital in Rabat, the capital of Morocco, from January 2000 to August 2019. Of the 443 enrolled patients, 320 (72.23%) were men and 123 (27.77%) were women. All patients were of Caucasian origin, from 12 Moroccan regions. The patient's samples were collected and subjected to serum protein electrophoresis and serum immunofixation electrophoresis to further characterize the monoclonal protein. The mean ± SD age of the 443 participants was 62.24 ± 13.14 years. Reasons for being admitted to the hospital were as follows, bone pain (41.60%), renal failure (19.08%), alteration of the general condition (12.21%), and anemia (10.69). Plasma cell proliferative disorders in our study were as follows, multiple myeloma (MM) (45.65%), Monoclonal gammopathies of undetermined significance (MGUS) (39.05%), Waldenstrom's macroglobulinemia (5.58%), Lymphoma (2.27% + 1.2%), Chronic Lymphocytic Leukemia (2.48%), Plasma cell leukemia (1.86%), Plasmacytoma (0.62%), POEMS syndrome (0.41%), and Amyloidosis (0.84%). The most frequent isotypes in MM were the IgGκ (62) 36.5%, IgGλ (52) 30.6%, IgAκ (27) 15.9%, and the IgAλ (19) 11.2%. It is also worth noting that Free light chain MM represents 20% of all cases of MM.
We found that monoclonal gammopathies are age-related and affects men more than women, also the results of this study point to the delayed diagnosis of monoclonal gammopathies, since most of our patients were diagnosed at the MM stage. The most frequent isotypes were the IgGκ and IgGλ in MM and MGUS, in Waldenström macroglobulinemia were IgMκ and IgMλ and the oligoclonal profile represented only 3.70%.
单克隆丙种球蛋白病是一组与浆细胞克隆性增殖相关的疾病，其产生单克隆蛋白。
本研究的主要目的是描述在摩洛哥一家教学医院 19 年间诊断的单克隆丙种球蛋白病的流行病学和免疫化学特征。
这项回顾性研究纳入了 443 名患有单克隆丙种球蛋白病的摩洛哥患者，这些患者符合摩洛哥拉巴特军事医院生化科的纳入和排除标准，纳入时间为 2000 年 1 月至 2019 年 8 月。443 名入组患者中，320 名（72.23%）为男性，123 名（27.77%）为女性。所有患者均为高加索人，来自摩洛哥的 12 个地区。采集患者样本进行血清蛋白电泳和血清免疫固定电泳，以进一步鉴定单克隆蛋白。443 名参与者的平均年龄为 62.24±13.14 岁。患者住院的原因如下，骨痛（41.60%）、肾衰竭（19.08%）、一般状况改变（12.21%）和贫血（10.69%）。浆细胞增生性疾病如下，多发性骨髓瘤（MM）（45.65%）、意义未明单克隆丙种球蛋白病（MGUS）（39.05%）、华氏巨球蛋白血症（5.58%）、淋巴瘤（2.27%+1.2%）、慢性淋巴细胞白血病（2.48%）、浆细胞白血病（1.86%）、浆细胞瘤（0.62%）、POEMS 综合征（0.41%）和淀粉样变性（0.84%）。在 MM 中最常见的同种型是 IgGκ（62）36.5%、IgGλ（52）30.6%、IgAκ（27）15.9%和 IgAλ（19）11.2%。值得注意的是，游离轻链 MM 占所有 MM 病例的 20%。
我们发现单克隆丙种球蛋白病与年龄相关，且男性多于女性，此外，本研究的结果表明单克隆丙种球蛋白病的诊断存在延迟，因为我们的大多数患者在 MM 阶段才被诊断出来。最常见的同种型是 MM 和 MGUS 中的 IgGκ和 IgGλ，在华氏巨球蛋白血症中是 IgMκ和 IgMλ，寡克隆图谱仅占 3.70%。
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