Bone-marrow immunophenotypic analysis allows the identification of high risk of progression and immune condition-related monoclonal gammopathy of undetermined significance.
BACKGROUND
Monoclonal gammopathy of undetermined significance (MGUS) progresses to plasma cell dyscrasia at a rate of 1% per year. A high prevalence of MGUS has been noted in series of patients with immune disorders or chronic infections.


METHODS
Retrospective cohort and a cross-sectional study to analyze the prognostic value of aberrant (CD38(+ +)CD138(+) CD19(-)CD45(weak)) to normal phenotype (CD38(+ +)CD138(+) CD19(+)CD45(+)) bone-marrow plasma cells ratio (A/N ratio) for the development of a plasma cell dyscrasia and the association with the presence of a chronic immune disorder.


RESULTS
A total of 322 patients were included with a median follow-up of 46 months. Analysis for progression revealed an increased A/N ratio as the main independent prognostic variable. A significant association between a reduced A/N ratio and the diagnosis of a chronic immune condition was found. Using receiver-operating characteristic analysis we created an A/N ratio range from 4 to 0.20. Values of 4 or higher define a group at high risk of progression (OR 10.7). A/N values of 0.20 or lower are associated with immune disorders or chronic infections (OR 20.9).


CONCLUSIONS
Extreme values of the A/N ratio seem to be related with two different conditions: high risk of progression, and immune condition-related MGUS.
Jerez
Andrés
A
Hospital Universitario J. M. Morales Meseguer, Hospital Universitario Reina Sofía, Murcia, Spain.
Ortuño
Francisco José
FJ
Osma
María Del Mar
Mdel M
Español
Ignacio
I
González
Ana Dolores
AD
Roldán
Vanessa
V
de Arriba
Felipe
F
Vicente
Vicente
V
D000368:Aged; D001327:Autoimmune Diseases / Q000150:complications* / Q000276:immunology; D001853:Bone Marrow / Q000276:immunology* / Q000473:pathology; D002471:Cell Transformation, Neoplastic; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D007239:Infections / Q000150:complications / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis*; D016017:Odds Ratio; D010265:Paraproteinemias / Q000097:blood; D010950:Plasma Cells / Q000473:pathology*; D011379:Prognosis; D012372:ROC Curve; D012044:Regression Analysis; D012189:Retrospective Studies; D012306:Risk