title: Prevalence and progression of monoclonal gammopathy of undetermined significance and light-chain MGUS in Germany.
abstract: We determined the prevalence and progression rate of monoclonal gammopathy of undetermined significance (MGUS) and light-chain MGUS (LCMGUS) in Germany utilizing the biobank of the population-based Heinz Nixdorf Recall Study. The Heinz Nixdorf Recall Study comprises 4,814 men and women aged 45-75 years. To detect monoclonal proteins, standard serum electrophoresis was combined with parallel screening immunofixation using pentavalent antisera. Additionally, free light chains (FLC) were measured in all samples. Definition of MGUS included M-protein concentration, laboratory results, and disease history. LCMGUS was defined as abnormal FLC ratio, increase in FLC causing the abnormal ratio, and lack of intact immunoglobulin. One hundred sixty-five MGUS cases were identified among 4,702 screened samples (prevalence 3.5%, 95% confidence interval (CI) 3.0-4.1; median age 63 years, range 47-75 years; 103 (62%) male; IgG 59%, IgA 17%, IgM 17%, biclonal 4.8%, kappa 56%, and lambda 44%). Five cases progressed (0.6%/year, 95% CI 0.2-1.4). An abnormal FLC ratio was detected in 220 samples. Thirty-nine of these showed intact immunoglobulin. Thirty-four of the remaining met LCMGUS criteria (prevalence 0.7%, 95% CI 0.5-1.0). None of the LCMGUS cases progressed. We demonstrate a MGUS prevalence of 3.5% and a LCMGUS prevalence of 0.7% in the general population aged 45-75 years in Germany using a sensitive screening approach.
authors.affiliation: Department of Hematology, University Hospital Essen, Hufelandstr. 55, 45122, Essen, Germany. lewin.eisele@uni-due.de
authors.forename: Lewin
authors.initials: L
authors.lastname: Eisele
authors.forename: Jan
authors.initials: J
authors.lastname: Dürig
authors.forename: Andreas
authors.initials: A
authors.lastname: Hüttmann
authors.forename: Ulrich
authors.initials: U
authors.lastname: Dührsen
authors.forename: Roland
authors.initials: R
authors.lastname: Assert
authors.forename: Beate
authors.initials: B
authors.lastname: Bokhof
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Klaus
authors.initials: K
authors.lastname: Mann
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.forename: Susanne
authors.initials: S
authors.lastname: Moebus
mesh_terms: D000368:Aged; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood*; D007145:Immunoglobulin kappa-Chains / Q000097:blood; D007146:Immunoglobulin lambda-Chains / Q000097:blood; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000097:blood* / Q000453:epidemiology* / Q000503:physiopathology*; D009194:Myeloma Proteins / Q000378:metabolism
chemical_list: D007147:Immunoglobulin Light Chains; D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains; D009194:Myeloma Proteins; C085016:multiple myeloma M-proteins