Role of different hematologic variables in defining the risk of malignant transformation in monoclonal gammopathy

摘要: The presenting clinico-hematologic features of 386 patients with nonmyelomatous monoclonal gammopathy (MG) were correlated the frequency malignant transformation to evaluate most important variables conditioning its evolution into multiple myeloma (MM) or Waldenstrom macroglobulinemia (WM). Most (335) had undetermined significance (MGUS: 39 IgA, 242 IgG, 54 IgM): remaining 51 (12 IgG) fulfilled all MGUS diagnostic criteria (according Durie) except that bone marrow plasma cell (BMPC) content was 10% 30%, and so they defined as having borderline (MGBS). There no significant differences between MGBS groups in terms age, sex, median follow-up. After a follow-up 70 53 months, respectively, 23 335 19 undergone evolution. Univariate analysis IgA IgG showed cumulative probability disease evolving MM definition (MGBS v MGUS), BMPC (> = 5%) reduced serum polyclonal Ig. In cases, there also correlation detectable Bence Jones proteinuria, component (MC) levels age at diagnosis 70, 3.6 13.1 for reduction one two conclusion, our study allows identification particular subset (MC < 1.5 g/dL, 5%, Ig light chain proteinuria) very low-risk evolution, who can be considered benign gammopathies. We describe previously undefined group MG (with significance) are high-risk These findings could have considerable impact on cost/benefit ratio monitoring programs these patients.