title: [Multiple myeloma after monoclonal gammopathy of uncertain significance. Study of 10 patients].
abstract: OBJECTIVE
  To analyse the clinical, biological and evolutive characteristics of 10 patients with multiple myeloma (MM) previously diagnosed of monoclonal gammopathy of uncertain significance (MGUS).
  
  
  METHODS
  Ten patients with diagnostic criteria of MM, included in a series of 114 subjects with MGUS, IgG (92 cases), IgA (21 cases) or biclonal IgG+IgA (1 case), diagnosed between 1970 and 1990, comprise this study group.
  
  
  RESULTS
  The actuarial risk of developing MM in the series of 114 MGUS was 7.25% (95% CI: 1.5-13) and 16.1% (05% CI: 4.7-27.5) at 5 and 10 years of follow-up, respectively. MM occurred suddenly, both on clinical and biological grounds, in 8 of the 10 patients. The median period between the diagnosis of MGUS and the onset of MM was 48 months (range, 12-153). IgG MM appeared in 5 instances and IgA MM in 5 others. Bone pain (7 cases) and hypercalcaemic encephalopathy (2 cases) were the commonest clinical manifestations. Osteolytic lesions were found in the x-ray scan in 9 patients. Eight patients received chemotherapy, objective response being seen in five of them. The median survival since the diagnosis of MM was 18 months (range, 0.1-95). The causes of death in 8 deceased patients include disease progression (4 cases), pneumonia (3 cases) and neoplasm of the bladder (1 case).
  
  
  CONCLUSIONS
  This analysis shows the difficulties in predicting the outcome of MGUS, since most of the MM seen here occurred abruptly and after a highly variable length of time. Thus, patients with MGUS must be followed-up for undetermined time.
authors.affiliation: Escuela de Hematología Farreras Valenti, Hospital Clínico y Provincial, Universidad de Barcelona.
authors.forename: C
authors.initials: C
authors.lastname: Salgado
authors.forename: J
authors.initials: J
authors.lastname: Bladé
authors.forename: A
authors.initials: A
authors.lastname: López-Guillermo
authors.forename: F
authors.initials: F
authors.lastname: Cervantes
authors.forename: E
authors.initials: E
authors.lastname: Montserrat
authors.forename: C
authors.initials: C
authors.lastname: Rozman
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000175:diagnosis / Q000453:epidemiology*; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D009194:Myeloma Proteins / Q000032:analysis; D010014:Osteolysis / Q000209:etiology; D015995:Prevalence; D012306:Risk; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D009194:Myeloma Proteins
vernacular_title: Mieloma múltiple tras gammapatía monoclonal de significado incierto. Estudio de 10 pacientes.