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Monoclonal gammopathy: natural history studied with a retrospective approach

From the Landspitali University Hospital, Department of Clinical Hematology (HS, VH); Landspitali University Hospital, Department of Clinical Chemistry (IO); University of Iceland, Faculty of Medicine (HS, HMO); Icelandic Heart Association (VG); The Icelandic Cancer Society (HMO)

Correspondence: Helga M. Ögmundsdóttir, Ph.D., Faculty of Medicine, University of Iceland, Vatnsm¢rarvegi 16, 101 Reykjavik, Iceland. E-mail: helgaogm{at}hi.is

The aim of this study was to examine the natural history of monoclonal gammopathy using a retrospective approach and a long observation period. Protein electrophoresis (PE) and immunofixation (IF) was performed on frozen prediagnosis serum samples from 65 multiple myeloma (MM) and 10 Waldenström’s macroglobulinemia (WM) cases. Paraprotein was found in 28% and 46% of the samples from cases using PE and IF respectively. The type of paraprotein was IgA in 33.4% of cases, IgG in 57%, and IgM in 8.5%. Excluding light chain or non-secretory disease, 72 % of MM cases had a prodromal MGUS phase within 10 years of diagnosis MM and WM were preceded by MGUS in at least half of the cases, confirming the premalignant nature of this condition.

Key words: monoclonal gammopathy of undetermined significance, multiple myeloma, Waldenstöm’s macroglobulinemia, natural history.