Individual serum proteins and acute phase reactants in monoclonal immunoglobulinopathies. A study in patients with macroglobulinemia.

Thirty-four patients with primary macroglobulinemia (Waldenström) were compared with healthy subjects and myeloma patients previously studied regarding their levels of 17 specific serum proteins. Quantitative changes of individual serum proteins were discussed with the respect to their biologic functions. Moreover linear correlations between the serum proteins studied were examined. Selected hematological data at diagnosis of macroglobulinemia have been also reported. The concentration of IgM monoclonal component (MC) was in 88% of macroglobulinemic sera above 1000 mg/dl. If no hyperproteinemia and IgM excess are concerned 5 proteins were found elevated (orosomucoid, alpha1-antitrypsin, ceruloplasmin, C-reactive protein (CRP), hemopexin) and 7 were decreased (prealbumin, albumin, alpha2HS glycoprotein, transferrin, C3-component, IgA, IgD). Differences in mean levels of 4 proteins (haptoglobin, alpha2 macroglobulin, beta2-glycoprotein I, IgG) did not reach statistical significance. CRO was demonstrable in two-thirds of patients and the CRO levels more than 1 mg/dl were noticed in a half of them. changes of phase proteins in macroglobulinemia were similar to those observed in myeloma and other malignancies. In the present series as previously in myeloma no positive relationship could be demonstrated between the concentration of MC and individual acute phase proteins. The levels of polyclonal IgG and IgA, not IgD were found significantly higher in macroglobulinemia than in myeloma, thus polyclonal formula in macroglobulinemia being more favorable. In contrast to myeloma the IgM MC showed at 5% level no significant negative correlation with polyclonal immunoglobulins (IgG, IgA, IgD) among which positive mutual correlations were noticed.