title: The Immunotyping Distribution of Serum Monoclonal Paraprotein and Environmental Impact on Multiple Myeloma (MM) and Monoclonal Gammopathy of Uncertain Significance (MGUS) in Taiwan: A Medical Center-Based Experience.
abstract: BACKGROUND
  Whether ambient exposure to environmental pollutants leads to hematopoietic malignancies such as multiple myeloma (MM) remains to be ascertained. Therefore, we aimed to investigate the immunotyping distribution of serum monoclonal paraprotein and the environmental influence on MM and monoclonal gammopathy of uncertain significance (MGUS) in the Taiwanese population.
  
  
  METHODS
  Serum protein electrophoresis with immunosubtraction by the capillary zone electrophoresis method was performed as primary screening for MM and MGUS. Clinical, pathological, and residence data of patients were also obtained.
  
  
  RESULTS
  From August, 2013 to June, 2015, a total of 327 patients underwent serum protein electrophoresis with immunosubtraction. Among these, 281 demonstrated no remarkable findings or non-malignant oligoclonal gammopathy, 23 were detected to have MGUS, 18 were identified as MM, and a further 5 were found as other malignancies. The most frequent immunotyping distribution of serum monoclonal paraprotein was IgG kappa (54.3%, n=25), followed by IgA lambda (15.2%, n=7) and IgG lambda (10.9%, n=5) in subjects with gammopathy. Additionally, it was shown that the elderly (OR: 4.61, 95% CI: 1.88-11.30, P<0.01) and males (OR: 2.04, 95% CI: 1.04-4.02, P=0.04) had significantly higher risk of developing MM and MGUS. There was no obvious impact of environmental factors on the health risk of MM and MGUS evolution (OR: 0.77, 95% CI: 0.40-1.50, P=0.49).
  
  
  CONCLUSIONS
  The most frequent immunotyping distribution of serum monoclonal paraprotein included IgG kappa, IgA lambda and IgG lambda in MM and MGUS in the Taiwanese population. The elderly and male subjects are at significantly higher risk of MM and MGUS development, but there was no obvious impact of environmental factors on risk.
authors.affiliation: Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan E-mail : jacpha@mail.femh.org.tw.
authors.forename: Chih-Chun
authors.initials: CC
authors.lastname: Chang
authors.forename: Ming-Jang
authors.initials: MJ
authors.lastname: Su
authors.forename: Shu-Jene
authors.initials: SJ
authors.lastname: Lee
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Tsai
authors.forename: Lin-Yin
authors.initials: LY
authors.lastname: Kuo
authors.forename: I-Hsin
authors.initials: IH
authors.lastname: Lin
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Huang
authors.forename: Tzung-Hai
authors.initials: TH
authors.lastname: Yen
authors.forename: Fang-Yeh
authors.initials: FY
authors.lastname: Chu
mesh_terms: D000368:Aged; D004777:Environment; D005260:Female; D006761:Hospitals; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D016130:Immunophenotyping / Q000379:methods; D008297:Male; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000097:blood* / Q000276:immunology* / Q000378:metabolism; D009101:Multiple Myeloma / Q000097:blood* / Q000276:immunology* / Q000378:metabolism; D010266:Paraproteins / Q000276:immunology* / Q000378:metabolism*; D013624:Taiwan
chemical_list: D007070:Immunoglobulin A; D007074:Immunoglobulin G; D010266:Paraproteins