Monoclonal gammopathy of undetermined significance (MGUS)-31 year follow up of a community study.
BACKGROUND
When unselected healthy adults in the community have their serum screened by cellulose acetate or paper electrophoresis, monoclonal gammopathy of undetermined significance (MGUS) may be found in 0.5-1%.


OBJECTIVE
To report upon a 31 year follow up of MGUS in a New Zealand community.


METHODS
Serum from 2,192 subjects (82% of the adult population) of a New Zealand town was collected in 1967 and subsequently screened by cellulose acetate electrophoresis. Eleven of the 2,192 (0.5%) were found to have MGUS. Clinical correlation was sought in 1970 and subsequently to elucidate the underlying cause.


RESULTS
Seven of the 11 patients have developed a haematological malignancy. Two have been diagnosed as having Waldenstrom's macroglobulinaemia, one malignant lymphoma and acute myelomonocytic leukaemia and four developed myeloma. Myeloma developed at one, nine, 23 and 25 years after the original screening. One myeloma patient and one patient with MGUS are currently alive and well, 31 years after discovery of their gammopathy.


CONCLUSIONS
The incidence of MGUS in this community is only half that detected in a comparable study. The association with haematological malignancy in this study (64%) is considerably higher than that found in the Swedish study (6%), possibly because of the longer follow up in New Zealand. MGUS should not only be studied in depth at the time of its discovery, but needs very long term follow up as the underlying disease may not surface until the third decade.
Colls
B M
BM
Oncology Service, Christchurch Hospital, New Zealand.
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D015994:Incidence; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D010265:Paraproteinemias / Q000150:complications / Q000453:epidemiology*; D008258:Waldenstrom Macroglobulinemia / Q000150:complications
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M