title: Biclonal gammopathies: Retrospective study of 47 patients.
abstract: OBJECTIVE
  Biclonal gammopathies are characterized by the clonal proliferation of plasma cells or their B-lymphoid progenitors and are associated with the production of abnormal immunoglobulins (M proteins or paraproteins). There are no known studies that have analyzed this disease in Spain. We studied the underlying diseases, characteristics of paraproteins and the evolution of a series of patients with biclonal gammopathy.
  
  
  METHODS
  We reviewed clonal gammopathies at the Department of Immunology of Hospital Puerta de Hierro in Madrid, between 1970 and 2011, selecting those patients with biclonal gammopathy in one reading. We collected data on the patient's epidemiology, underlying disease, associated diseases, therapies and paraprotein and immunoglobulin levels.
  
  
  RESULTS
  Of the 1626 cases of clonal gammapathies, 47 were biclonal gammopathy (2.89%). The median follow-up was 2 years. The main associated condition was biclonal gammopathies of undetermined significance (BGUS). The most common paraprotein combination was IgG-IgG. Upon conducting a second paraprotein reading, 81% of the patients had lost at least 1 monoclonal component. A third of the patients had not undergone treatment.
  
  
  CONCLUSIONS
  Biclonal gammopathy are fundamentally associated with biclonal gammopathies of undetermined significance. No biclonal gammopathies of undetermined significance evolved to a malignant disease. In a high percentage of patients, at least 1 of the 2 clonal components disappeared, sometimes spontaneously.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
authors.forename: P
authors.initials: P
authors.lastname: García-García
authors.affiliation: Servicio de Inmunología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
authors.forename: K
authors.initials: K
authors.lastname: Enciso-Alvarez
authors.affiliation: Servicio de Inmunología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
authors.forename: F
authors.initials: F
authors.lastname: Diaz-Espada
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Vargas-Nuñez
authors.affiliation: Servicio de Inmunología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Moraru
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España. Electronic address: myebrb@terra.com.
authors.forename: M
authors.initials: M
authors.lastname: Yebra-Bango
keywords: Biclonal gammopathy; Gammapatía biclonal; Gammapatía de significado incierto; Gammopathy of undetermined significance; M protein; Paraproteins; Paraproteínas; Proteína M