Monoclonal gammopathies in the adult population of Finistère, France.

Saleun, J.P.; Vicariot, M.; Deroff, P.; Morin, J.

doi:10.1136/jcp.35.1.63

Cited by 181 publications

(115 citation statements)

References 18 publications

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“…For many years, it was considered that the prevalence of MGUS was 1 and 3 % in persons older than 50 and 70 years, respectively. [10][11][12][13][14] However, in a recent study performed on residents of Olmsted County (MN, USA), the prevalence of MGUS has been found to be even higher than what was previously reported (that is, 3.2 and 5.3% in persons older than 50 and 70 years, respectively). The median age at diagnosis is around 70 years and less than 2% patients with MGUS are under the age of 40 years.…”

Section: Epidemiologymentioning

confidence: 39%

Pathogenesis and progression of monoclonal gammopathy of undetermined significance

et al. 2008

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In Caucasians, monoclonal gammopathy of undetermined significance (MGUS) is an age-related condition with prevalence as high as 3% in persons older than 50 years. Compared with whites, blacks have around two-and threefold higher prevalence rates of MGUS and multiple myeloma (MM), respectively. Risk of progression from MGUS to MM has been found to be very similar in whites and blacks. On average, the transformation rate to a malignant monoclonal gammopathy is 1% per year, with the mechanisms of progression likely related to bone marrow microenvironment and/or the cytokine network. Overall, the actuarial probability of progression at 25 years of follow-up is about 30%. However, when the competing causes of death are taken into account, the actual rate of progression is only 11%. The predictors of malignant transformation are the plasma cell mass (M-protein size and/or proportion of plasma cell in the bone marrow), IgA isotype, serum free light-chain ratio and 'evolving' type and ratio between phenotypically aberrant and normal bone marrow plasma cells. It is recommended to follow these patients, particularly those with high risk of progression, annually to detect MM before complications, such as renal failure or extensive skeletal, involvement occur. Leukemia ConceptThe term monoclonal gammopathy of undetermined significance (MGUS) indicates the presence of a monoclonal protein (M-protein) in individuals with no features of multiple myeloma (MM), Waldenströ m's macroglobulinemia, primary amyloidosis or other related disorders. 1 Patients with MGUS have a serum M-protein size lower than 3 g per 100 ml, and proportion of bone marrow plasma cells of less than 10%, with no clinical manifestations related to their monoclonal gammopathy (Table 1). 1,2 MGUS was initially considered to be a benign condition and was frequently named 'benign' or 'idiopathic' monoclonal gammopathy. 3,4 However, from the time of the pioneer observations in the Mayo Clinic (Rochester, MN, USA) series, this disorder could no longer be considered as 'benign' as a number of patients ultimately develop a malignant monoclonal gammopathy. 1,[5][6][7][8] For this reason, Dr Robert Kyle coined the term 'monoclonal gammopathy of undetermined significance'. 1,5 Considering that MGUS is usually an unexpected finding in a routine medical survey, or in the study of an unrelated disorder, not surprisingly, this condition is usually first seen by physicians working in many different fields of medical practice. In consequence, it is crucial to know the significance of the finding: whether it will require further investigation and whether it will remain stable or, by the contrary, will evolve into a symptomatic monoclonal gammopathy requiring therapeutic intervention. 9 EpidemiologyPrior studies based on Caucasians showed that the prevalence of MGUS increases with age. For many years, it was considered that the prevalence of MGUS was 1 and 3 % in persons older than 50 and 70 years, respectively. 10-14 However, in a recent study performed on residents of Olms...

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Section: Epidemiologymentioning

confidence: 39%

Pathogenesis and progression of monoclonal gammopathy of undetermined significance

et al. 2008

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“…However, a higher risk of MGUS has been demonstrated in farmers, industry workers, and those with a history of occupational or environmental exposure to toxins. 39 Occupational exposure to asbestos, aromatic hydrocarbons, fertilizers, mineral oils and petroleum, paints and related products, pesticides, and radiation is also significantly associated with an increased risk of MGUS. 40,41 A link also exists between heavy tobacco smoking and various hematologic conditions, including MGUS.…”

Section: Sexmentioning

confidence: 99%

“…On average, the prevalence of MGUS is 1.5 times higher in men than in women. 13,15,16,18,20,21,39,49 Differences in age composition of cohorts between studies influence sex-specific prevalence estimates because the condition is very rare in those younger than 40 years. For example, the population-based study by Axelsson et al 16 reported a prevalence of 1.1% in men and 0.8% in women aged 25 to 99 years.…”

Section: Sexmentioning

confidence: 99%

Prevalence of Monoclonal Gammopathy of Undetermined Significance: A Systematic Review

Wadhera

Rajkumar

2010

Mayo Clinic Proceedings

131

104

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M onoclonal gammopathy of undetermined significance (MGUS) is a premalignant, asymptomatic disorder characterized by monoclonal plasma cell proliferation in bone marrow with absence of end-organ damage. 1 Although historically considered a benign condition, patients with MGUS have a lifelong risk of multiple myeloma, an incurable plasma cell malignancy with a median survival of approximately 4 to 5 years. [2][3][4] Patients with MGUS are also at risk of related disorders, such as light-chain amyloidosis and macroglobulinemia. Conditions such as osteoporosis, hip fractures, and peripheral neuropathy are also associated with MGUS. 5 The rate at which MGUS progresses to multiple myeloma or a related disorder is 1% per year. 6,7 The probability of progression at 25 years of follow-up is approximately 30%. However, after accounting for competing causes of death, true life-time probability of progression is lower (11%). 8 The risk of progression with MGUS does not diminish over time Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant plasma cell disorder that is associated with a lifelong risk of multiple myeloma. We conducted a systematic review of all studies investigating the prevalence and incidence of MGUS in the online database PubMed. The review was conducted from January 6, 2009, through January 15, 2010. The following MeSH search headings were used: monoclonal gammopathy, benign and prevalence; monoclonal gammopathy, benign and incidence; paraproteinemia and prevalence; and paraproteinemia and incidence. Articles were limited to those written in English and published by January 2009. Fourteen studies that met prespecified criteria were included and systematically assessed to identify the most accurate prevalence estimates of MGUS based on age, sex, and race. On the basis of our systematic review, we estimate that the crude prevalence of MGUS in those older than 50 years is 3.2% in a predominantly white population. Studies in white and Japanese populations demonstrate a clear increase in prevalence with age. The prevalence is also affected by sex: 3.7% and 2.9% in white men and women, respectively; and 2.8% and 1.6% in Japanese men and women, respectively. Additionally, MGUS is significantly more prevalent in black people (5.9%-8.4%) than in white people (3.0%-3.6%). We conclude that MGUS is a common premalignant plasma cell disorder in the general population of those older than 50 years. The prevalence increases with age and is affected by race, sex, family history, immunosuppression, and pesticide exposure. These results are important for counseling, clinical care, and the design of clinical studies in high-risk populations. and persists even in patients whose condition has remained stable for decades. 7,9 This fixed risk of progression regardless of duration of disease suggests a random 2-hit model of progression rather than a cumulative damage accumulation model in which the risk of progression would be expected to increase with duration of MGUS. The main risk factors for progressio...

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“…On the basis of a limited number of reports, IgM MGUS appears to be substantially less frequent in Eastern Europe (38), Greece (39), and Israel (29) and intermediate in southern European countries such as Spain (41) and Italy (37). Geographical variation also appears within populations of western European descent (42,44,47). In particular, a study of blood donors in France demonstrated remarkable variation by region, ranging from 0% (in a group of mostly urban dwellers in Paris) to 33% (in residents of an agricultural district in western France) (44).…”

Section: S93mentioning

confidence: 99%

“…Others evaluate defined population of interest, such as atomic bomb survivors (27) or elderly residents in a retirement home (31,34). A few represent unselected registry-based (36) or geographically defined (16,26,43,47,48) populations.…”

Section: S93mentioning

confidence: 99%

Prevalence, clinical aspects, and natural history of IgM MGUS

McMaster

Landgren

2010

Cytometry Part B Clinical

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Results: There appears to be marked heterogeneity in the prevalence of IgM MGUS across populations. However, studies have varied in definition, design, laboratory methods, and endpoints. IgM MGUS differs from non-IgM MGUS in certain respects, including prevalence across racial groups, rate of progression, and pattern of malignant outcomes. There are limited data regarding the coincident occurrence of IgM MGUS and MBL.Conclusions: Future studies incorporating both protein electrophoresis and flow cytometry are needed to define the underlying spectrum and causes of precursor development, risk factors for progression, and markers that distinguish low-and high-risk precursor patients. Published

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Monoclonal gammopathies in the adult population of Finistère, France.

Cited by 181 publications

References 18 publications

Pathogenesis and progression of monoclonal gammopathy of undetermined significance

Pathogenesis and progression of monoclonal gammopathy of undetermined significance

Prevalence of Monoclonal Gammopathy of Undetermined Significance: A Systematic Review

Prevalence, clinical aspects, and natural history of IgM MGUS

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