title: Monoclonal gammopathy of undetermined significance and risk of infections: a population-based study.
abstract: No comprehensive evaluation has been made to assess the risk of viral and bacterial infections among patients with monoclonal gammopathy of undetermined significance. Using population-based data from Sweden, we estimated risk of infections among 5,326 monoclonal gammopathy of undetermined significance patients compared to 20,161 matched controls. Patients with monoclonal gammopathy of undetermined significance had a 2-fold increased risk (P<0.05) of developing any infection at 5- and 10-year follow up. More specifically, patients with monoclonal gammopathy of undetermined significance had an increased risk (P<0.05) of bacterial (pneumonia, osteomyelitis, septicemia, pyelonephritis, cellulitis, endocarditis, and meningitis), and viral (influenza and herpes zoster) infections. Patients with monoclonal gammopathy of undetermined significance with M-protein concentrations over 2.5 g/dL at diagnosis had highest risks of infections. However, the risk was also increased (P<0.05) among those with concentrations below 0.5 g/dL. Patients with monoclonal gammopathy of undetermined significance who developed infections had no excess risk of developing multiple myeloma, Waldenström macroglobulinemia or related malignancy. Our findings provide novel insights into the mechanisms behind infections in patients with plasma cell dyscrasias, and may have clinical implications.
authors.affiliation: Department of Medicine, Division of Hematology, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden. sigurdur.kristinsson@karolinska.se
authors.forename: Sigurdur Y
authors.initials: SY
authors.lastname: Kristinsson
authors.forename: Min
authors.initials: M
authors.lastname: Tang
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Pfeiffer
authors.forename: Magnus
authors.initials: M
authors.lastname: Björkholm
authors.forename: Lynn R
authors.initials: LR
authors.lastname: Goldin
authors.forename: Cecilie
authors.initials: C
authors.lastname: Blimark
authors.forename: Ulf-Henrik
authors.initials: UH
authors.lastname: Mellqvist
authors.forename: Anders
authors.initials: A
authors.lastname: Wahlin
authors.forename: Ingemar
authors.initials: I
authors.lastname: Turesson
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood / Q000276:immunology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D012306:Risk; D013548:Sweden / Q000453:epidemiology; D014777:Virus Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000276:immunology
chemical_list: D007136:Immunoglobulins; C009823:M-proteins (Myeloma)