[A series of 618 cases of monoclonal gammopathies of undetermined significance: predictive factors of disappearance of monoclonal component or evolution to malignant gammopathies].
BACKGROUND
How to identify monoclonal gammopathies of undeterminated significance (MGUS) at risk for progression has been studied for the last years.


OBJECTIVE
To study the incidence of MGUS in a region with 300,000 inhabitants and factors which associate with a) monoclonal gammopathy disappearance (transient MGUS) b) evolution to malignant gammopathy.


METHODS
Study of 618 MGUS.


RESULTS
Incidence: 30/40 new cases a year with increase to 70 cases a years in the latest years of study. Age and gender: 71,4 y (32-100), male/female ratio 1.4. Associated pathology: infection 328, heart diseases 249, rheumatic diseases 211, liver diseases 108, cancer 80, neuropathy 43. Monoclonal proteins: IgG 407, IgM 78, IgD 2, biclonal 16, triclonal 1; no heavy chain 21, light chain Kappa 389. Variables (mean): monoclonal component: 14 g/l, ESR 32,5, bone marrow: 5,9% plasma cells beta2-microglobulin: 2,59 mg/l, albumin: 3,1g/l, bone survey: normal 39,5%. Evolution: transient MGUS 20 cases. Time to disappearance 2,6 months (1,4-4,6). Evolution to malignant gammopathy 24 cases, time to progression 3 years (IC 1,82-4,3).


RESULTS
Several factors were associatedç with malignant transformation: heavy chain IgA (p < 0,002), ESR (p < 0,001), age < 70 (p < 0,05), bone marrow percentage of plasma cells (p < 0,002) y ostheoporosis (p < 0,005). A MGUS follow up model is suggested.
González García
M E
ME
Servicio de Hematología-Hemoterapia, Hospital de Cabueñes, Gijón, Asturias, España. esthergongar@yahoo.es
Fernández Alvarez
C
C
Robles Marinas
V
V
González Huerta
A J
AJ
Arias Miranda
M I
MI
González Rodríguez
A P
AP
García Casas
J
J
de La Tassa
J Moris
JM
Fernández García
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002471:Cell Transformation, Neoplastic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010265:Paraproteinemias / Q000453:epidemiology* / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors