Document Detail

The natural history of monoclonal gammopathy of undetermined significance. A 5- to 20-year follow-up of 263 cases.
MedLine Citation:
PMID:  9066713     Owner:  NLM     Status:  MEDLINE    
Patients with monoclonal gammopathy of undetermined significance (MGUS) have a serum monoclonal component (M-component), but no evidence of multiple myeloma, macroglobulinaemia, amyloidosis or other plasma cell proliferative disease. A long-term follow-up study (median 11.5 years) has been carried out in 263 cases of MGUS, 159 males (60.5%) and 104 females (39.5%), aged 40-89 years (median 66.5 years). The actuarial probability for malignant transformation was 6.1, 15.4 and 31.3% at 5, 10 and 20 years, respectively. At the final evaluation, 157 patients (59.7%), 119 (45.3%) of whom with no increase and 38 (14.4%) with an increase in serum M-component, died of causes unrelated to MGUS and without development of any plasma cell proliferative disease; 47 patients (17.9%) were still alive without increase in M-component; 11 patients (4.1%) were still alive and at follow-up presented values of serum M-component > 30 g/l without any evidence of plasma cell proliferative or lymphoproliferative disease; 48 patients (18.3%) developed multiple myeloma (35 cases, 13.1%), solitary plasmacytoma of the bone (2 cases, 0.8%), macroglobulinaemia (4 cases, 1.6%), malignant lymphoma (3 cases, 1.2%), amyloidosis (2 cases, 0.8%), chronic lymphocytic leukaemia (1 case, 0.4%), and plasma cell leukaemia (1 case, 0.4%). The patients developing multiple myeloma, solitary plasmacytoma, macroglobulinaemia and plasma cell leukaemia had an increase in serum M-component, whereas no increase was found in malignant lymphoma, amyloidosis and chronic lymphocytic leukaemia. These findings and the data in the literature suggest that MGUS could be considered a preneoplastic condition; since no clinical and laboratory features are able to identify in advance the patients at high risk of disease progression, each patient must be followed up indefinitely.
P Pasqualetti; V Festuccia; A Collacciani; R Casale
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta haematologica     Volume:  97     ISSN:  0001-5792     ISO Abbreviation:  Acta Haematol.     Publication Date:  1997  
Date Detail:
Created Date:  1997-04-08     Completed Date:  1997-04-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0141053     Medline TA:  Acta Haematol     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  174-9     Citation Subset:  IM    
Department of Internal Medicine and Public Health, School of Medicine and Surgery, University of L'Aquila, Italy.
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MeSH Terms
Aged, 80 and over
Follow-Up Studies
Middle Aged
Paraproteinemias / physiopathology*
Risk Factors

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