Triclonal gammopathy in an extranodal non‐Hodgkin lymphoma patient

Tirelli, A; Guastafierro, Salvatore; Cava, Benedetto; Lucivero, Giacomo

doi:10.1002/ajh.10338

Cited by 11 publications

(9 citation statements)

References 6 publications

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“…The close relationship of MZ B cells with plasma cells suggests a potential for immunoglobulin production by MALT lymphoma cells, which has been reported by various authors, albeit in anecdotal form (7)(8)(9)(10). To date, however, no systematic investigations to assess the frequency of monoclonal immunoglobulin/PP production have been performed in patients with MALT lymphoma.…”

Section: Introductionmentioning

confidence: 90%

Monoclonal Immunoglobulin Production Is a Frequent Event in Patients with Mucosa-Associated Lymphoid Tissue Lymphoma

Wöhrer¹,

Streubel²,

Bartsch³

et al. 2004

Clinical Cancer Research

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Purpose: Mucosa-associated lymphoid tissue (MALT) lymphoma comprises 7% of all newly diagnosed nonHodgkin's lymphomas and is therefore among the most common lymphoma entities. Monoclonal gammopathy due to production of a monoclonal immunoglobulin by lymphoma cells is a well-known phenomenon associated with various types of B-cell non-Hodgkin's lymphomas. The objective of the present study was to evaluate the incidence and clinical relevance of paraprotein (PP) production in patients with MALT lymphoma.Experimental Design: Fifty two patients were prospectively evaluated with regard to differentiation of the MALT lymphoma cells, t(11;18) translocation, monoclonal immunoglobulin production, Helicobacter pylori (HP) status, stage, treatment, and clinical outcome.Results: Nineteen of 52 MALT lymphoma patients (36%) had PP (8 IgM, 6 IgG, 4 IgM, and 1 IgA). The histologic feature of plasmacytic differentiation correlated significantly with the production of PP (P ‫؍‬ 0.001). No correlation was found between PP and clinical stage, HP status, and t(11;18) status. PP was, however, negatively associated with response to eradication of HP in gastric MALT lymphoma, and PP levels declined significantly in patients responding to chemotherapy or radiation. Importantly, both immunofixation and serum electrophoresis have to be performed to detect low PP levels.Conclusions: In conclusion, PP levels may probably be used as a potential prognostic tool for response to HP eradication, and serial measurements may also allow for noninvasive assessment of response to radiation or chemotherapy in patients with MALT lymphoma.

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Section: Introductionmentioning

confidence: 90%

Monoclonal Immunoglobulin Production Is a Frequent Event in Patients with Mucosa-Associated Lymphoid Tissue Lymphoma

Wöhrer¹,

Streubel²,

Bartsch³

et al. 2004

Clinical Cancer Research

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“…In a review of 24 patients with triclonal gammopathy, 16 were associated with a malignant lymphoproliferative disorder, five occurred in non‐haematological disease and three were of undetermined significance (Grosbois et al , 1997). In another report, three separate populations of M protein‐producing cells were identified in a patient with NHL (Tirelli et al , 2003).…”

Section: Variants Of Mgusmentioning

confidence: 97%

Monoclonal gammopathy of undetermined significance and smouldering multiple myeloma: emphasis on risk factors for progression

2007

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SummaryMonoclonal gammopathy of undetermined significance (MGUS) is characterized by a serum monoclonal protein <30 g/l, <10% plasma cells in the bone marrow, and absence of end-organ damage (CRAB-hypercalcaemia, renal insufficiency, anaemia, or bone lesions). MGUS is present in 3% of persons >50 years and in 5% >70 years of age. The risk of progression to multiple myeloma (MM) or a related disorder is 1% per year. Patients with risk factors consisting of an abnormal serum free light chain ratio, non-immunoglobulin G (IgG) MGUS, and an elevated serum M protein ‡15 g/l had a risk of progression at 20 years of 58%, compared with 37% with two risk factors present, 21% with one risk factor present, and 5% when none of the risk factors were present. Smouldering (asymptomatic) multiple myeloma is characterized by having a serum IgG or IgA monoclonal protein of 30 g/l or higher and/or 10% or more plasma cells in the bone marrow but no evidence of end-organ damage. The cumulative probability of progression to active MM or amyloidosis was 51% at 5 years, 66% at 10 years and 73% at 15 years; the median time to progression was 4AE8 years.

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“…Over the two outbreak seasons in two recent years, 18 cases (20%) of variant patterns of MG/OG, including rare patterns (same type of heavy and light chains and TG), were observed in 90 samples from patients who were clinically diagnosed with scrub typhus. 3 The prevalence of MG/OG in scrub typhus was approximately 10-12 times higher than in age-matched persons who were infected with hepatitis C virus (1/60) and controls without infection (2/100) (Park DS, Cho JH, unpublished data). However, it was difficult to provide a prognosis and decide on a diagnostic approach, including the timing of serial testing, because of the absence of specific clinical information about the course of either MG or OG in patients with scrub typhus.…”

Section: Discussionmentioning

confidence: 99%

“…1 Triclonal gammopathies (TGs) are much rarer than BGs and their incidence is unknown. 3 All three gammopathies frequently require further invasive or cost-intensive diagnostic procedures, such as bone marrow examination, for proper diagnosis of the underlying disorder.…”

Section: Introductionmentioning

confidence: 99%

Clinical Course of Monoclonal and Oligoclonal Gammopathies in Patients Infected with Orientia tsutsugamushi

Park

Cho²,

Lee³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

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Abstract. Although we have encountered many cases of monoclonal gammopathies (MGs) or oligoclonal gammopathies (OGs) in patients with Orientia tsutsugamushi infections, the clinical course of MG/OG associated with these infections has rarely been reported. We serially monitored 18 cases of MG/OG that appeared in the acute phase or early convalescent phase of scrub typhus. All MGs/OGs associated with infection with O. tsutsugamushi disappeared 7-15 weeks after treatment with doxycycline. In three cases of scrub typhus, MGs/OGs appeared before seropositive conversion (presence of antibodies against O. tsutsugamushi ) and disappeared before seronegative conversion. Understanding our cases may be helpful for relevant clinical counseling and making appropriate medical decisions to avoid unnecessary invasive or cost-intensive diagnostic procedures for MGs/OGs in scrub typhus, especially in disease-endemic areas. We also suggest that 2-4 months after antibiotic treatment might be the optimal follow-up time to observe the disappearance of MGs/OGs associated with O. tsutsugamushi infections.

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Triclonal gammopathy in an extranodal non‐Hodgkin lymphoma patient

Cited by 11 publications

References 6 publications

Monoclonal Immunoglobulin Production Is a Frequent Event in Patients with Mucosa-Associated Lymphoid Tissue Lymphoma

Monoclonal Immunoglobulin Production Is a Frequent Event in Patients with Mucosa-Associated Lymphoid Tissue Lymphoma

Monoclonal gammopathy of undetermined significance and smouldering multiple myeloma: emphasis on risk factors for progression

Clinical Course of Monoclonal and Oligoclonal Gammopathies in Patients Infected with Orientia tsutsugamushi

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