title: Malignant transformation and life expectancy in monoclonal gammopathy of undetermined significance.
abstract: The actuarial probability of malignant transformation and the impact on expected survival were analysed in a series of 128 persons diagnosed with monoclonal gammopathy of undetermined significance (MGUS) over a 20-year period. At a median follow-up of 56 months the M-component remains stable in 101 patients (78.9%), 14 patients (10.9%) have died from non-related disorders and 13 (10.2%) have developed malignant transformation of MGUS (multiple myeloma, 10; primary amyloidosis, two; Waldenström's macroglobulinaemia, one). The actuarial probability of malignant transformation at 5 and 10 years was 8.5% and 19.2%, respectively. When different presenting features were analysed for predictive value of the malignant transformation, the IgA type of MGUS was the only variable associated with a higher probability of such an event (P less than 0.025). Although no significant difference was observed between the survival probability of persons with MGUS and that of the control population, the development of malignant transformation was associated with a shorter survival (P less than 0.001).
authors.affiliation: Postgraduate School of Haematology Farreras-Valentí, Hospital Clínic i Provincial, University of Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Blade
authors.forename: A
authors.initials: A
authors.lastname: Lopez-Guillermo
authors.forename: C
authors.initials: C
authors.lastname: Rozman
authors.forename: F
authors.initials: F
authors.lastname: Cervantes
authors.forename: C
authors.initials: C
authors.lastname: Salgado
authors.forename: J L
authors.initials: JL
authors.lastname: Aguilar
authors.forename: J L
authors.initials: JL
authors.lastname: Vives-Corrons
authors.forename: E
authors.initials: E
authors.lastname: Montserrat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D010265:Paraproteinemias / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology*; D011336:Probability; D008258:Waldenstrom Macroglobulinemia / Q000453:epidemiology / Q000401:mortality / Q000473:pathology