Gregersen H, Madsen K M, Sørensen H T, Schønheyder H C, Ibsen J S, Dahlerup J F
Department of Clinical Immunology, Aalborg Hospital, Denmark.
Eur J Haematol. 1998 Aug;61(2):140-4. doi: 10.1111/j.1600-0609.1998.tb01075.x.
We estimated the risk of bacteremia in patients with monoclonal gammopathy of undetermined significance (MGUS) compared with the general population; 1237 cases of MGUS were identified by linking information on detected monoclonal components in the North Jutland County with the Danish Cancer Registry. We evaluated the risk of bacteremia in the MGUS cohort during the 13-yr period from 1981 to 1993 by linkage to the Bacteremia Registry in the County. Follow-up for the occurrence of bacteremia started 30 d after detection of the M-component and continued until malignant transformation, death or until 31 December 1993, whichever came first. The expected numbers of bacteremia was based upon county, age, sex and period-specific incidence rates. The median follow-up period was 3.8 yr. Forty episodes of bacteremia occurred during 5500 person-years versus 18 expected. The crude standardized incidence ratio of bacteremia was 2.2 (95% confidence interval, 1.6-3.0). There was no distinct pattern of bacterial etiology in the MGUS cohort. Although we found an association between MGUS and risk of bacteremia, the overall risk is small and this finding hardly affects the clinical handling of MGUS patients.
我们评估了意义未明的单克隆丙种球蛋白病（MGUS）患者与普通人群相比发生菌血症的风险；通过将北日德兰郡检测到的单克隆成分信息与丹麦癌症登记处相联系，确定了1237例MGUS病例。我们通过与该郡菌血症登记处相联系，评估了1981年至1993年这13年期间MGUS队列中菌血症的风险。菌血症发生情况的随访在检测到M成分后30天开始，持续至发生恶性转化、死亡或直至1993年12月31日（以先发生者为准）。菌血症的预期病例数基于郡、年龄、性别以及特定时期的发病率。中位随访期为3.8年。在5500人年中发生了40例菌血症，而预期为18例。菌血症的粗标准化发病率比为2.2（95%置信区间，1.6 - 3.0）。MGUS队列中没有明显的细菌病因模式。虽然我们发现MGUS与菌血症风险之间存在关联，但总体风险较小，这一发现对MGUS患者的临床处理几乎没有影响。
