Kyle R A, Gleich G J
J Lab Clin Med. 1982 Nov;100(5):806-14.
One hundred seventy-five patients with a serum monoclonal IgG who had been followed up for more than 5 years without the development of multiple myeloma, amyloidosis, or other serious diseases were designated as having MGUS. The monoclonal IgG of 83% of patients was classified as IgG1; that of 9%, IgG2; that of 6%, IgG3; and that of 2%, IgG4. The median values for hemoglobin, leukocytes, platelets, calcium, creatinine, size of the M spike, and plasma cell content in the bone marrow were not significantly different in the four subclass groups. The IgA level was reduced in 8% and the IgM in 20% of the total group. The uninvolved IgG subclass levels were reduced in 81% of the IgG1 patients and in all the IgG2, IgG3, and IgG4 patients. The patients with MGUS wer compared to 229 patients with multiple myeloma. The monoclonal IgG of the myeloma patients was classified as IgG1 (73%), IgG2 (14%), IgG3 (8%), and IgG4 (6%). The median hemoglobin values were higher in IgG3 and IgG4 groups. Renal insufficiency and size of the M protein spike were similar in the four subclass groups. Either IgA or IgM was reduced in 75% of the patients. The uninvolved IgG subclasses were reduced in 96.5% of all patients. The 5-year actuarial survival was 30% for the IgG1 group and 33% for the IgG2 group. Twenty patients with MGUS subsequently developed multiple myeloma. Analysis of the results from these patients did not show a difference from the other MGUS patients. The results suggest that the IgG subclass in MGUS does not affect either the features of the disease or the tendency for later development of multiple myeloma.
175例血清单克隆IgG患者，随访5年以上未发生多发性骨髓瘤、淀粉样变性或其他严重疾病，被指定为意义未明的单克隆丙种球蛋白病（MGUS）。83%患者的单克隆IgG被分类为IgG1；9%为IgG2；6%为IgG3；2%为IgG4。四个亚类组的血红蛋白、白细胞、血小板、钙、肌酐、M峰大小和骨髓浆细胞含量的中位数无显著差异。IgA水平在总组的8%患者中降低，IgM在20%患者中降低。81%的IgG1患者和所有IgG2、IgG3和IgG4患者的未受累IgG亚类水平降低。将MGUS患者与229例多发性骨髓瘤患者进行比较。骨髓瘤患者的单克隆IgG分类为IgG1（73%）、IgG2（14%）、IgG3（8%）和IgG4（6%）。IgG3和IgG4组的血红蛋白中位数较高。四个亚类组的肾功能不全和M蛋白峰大小相似。75%的患者IgA或IgM降低。所有患者中96.5%的未受累IgG亚类降低。IgG1组的5年精算生存率为30%，IgG2组为33%。20例MGUS患者随后发生了多发性骨髓瘤。对这些患者结果的分析未显示与其他MGUS患者有差异。结果表明，MGUS中的IgG亚类既不影响疾病特征，也不影响后期发生多发性骨髓瘤的倾向。
