2004, Number 4
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Gac Med Mex 2004; 140 (4)
Monoclonal Gammopathy of Undetermined Significance (MGUS) in Mexican Mestizos: One Institution’s Experience.
Ruiz-Delgado GJ, Gómez RJD
Language: Spanish
References: 30
Page: 375-379
PDF size: 50.27 Kb.
ABSTRACT
Monoclonal gammopathy of undetermined significance
(MGUS) is defined as presence of serum monoclonal protein
at a concentration of 3 g per deciliter or less, no monoclonal
protein or only moderate amounts of monoclonal light chains
in urine, absence of lytic bone lesions, anemia, hypercalemia,
and renal insufficiency related with monoclonal protein, and
with a proportion of plasma cells in bone marrow of 10% or
less. In Caucasian population, MGUS affects about 3% of
individuals › 70 years of age, whereas in Mexican mestizos
this figure is substantially lower (0.7%); on the other hand,
MGUS represents in Mexico only 2.4% of all monoclonal
gammopathies. In a total of 9081 individuals studied
prospectively at the Centro de Hematología y Medicina
Interna de Puebla throughout a 20-year period, 11 patients
with MGUS were identified. Median age was 70 years (range
43-83 years). Patients have been followed in periods ranging
from 6 to 3270 days (median, 308 days). Two patients evolved
into overt multiple myeloma at 308 and 1687 days after
diagnosis of MGUS. Overall median survival (SV) of the
group has not been reached, whereas3270 days overall SV is
91%. After discussing underreporting, biasing, and other
confounding factors, it would seem that MGUS, like other
monoclonal gammopathies, is less frequent in Mexican mestizos
than in Caucasians. Routine screening studies to identify the
condition should result in increased numbers of patients.
REFERENCES
Ruiz-Reyes G, Ruiz-Argüelles A. Padecimientos inmunoproliferativos malignos. En Ruiz-Argüelles GJ (editor) Fundamentos de Hematología. 32 ed. México: Editorial Médica Panamericana;2003. pp. 323-341.
Kyle RA. Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma. Eur J Haematol 1989;(Suppl 1)51:70-75.
Hallen J. Frequency of "abnormal" serum globulins ( M-components) in the aged. Acta Med Scand 1963;173:737-744.
Hallen J. Discrete gammaglobulin (M-) components in serum: clinical study of 150 subjects without myelomatosis. Acta Med Scand 1966(Suppl 1);462:1-127.
Axelsson U, Bachmann R, Hallen J. Frequency of pathological proteins (Mcomponents) in 6995 sera from an adult population. Acta Med Scand 1966;179: 235-247.
Kyle RA, Finkeistein S, Elveback LR, Kurland LT. Incidence of monoclonal proteins in a Minnesota communlty with a cluster of multiple myeloma. Blood 1972;40:719-724.
Saleun JP, Vicarlot M, Deroff P, Morin JF. Monoclonal gammopathies in the adult population of Finisterre, France. J Clin Pathol 1982;35:63-68.
Kyle RA. Monoclonal gammopathy of undetermined significance: natural history in 241 cases. Am J Med 1978;64:814-826.
Kyle RA. Diagnosis of multiple myeloma. Sem Oncol 2002(suppl 17):2-4.
Chaibi P, Merlin L, Thomas C, Plette F. Monoclonal gammopathy of undetermined significance. Ann Med Inteme 2002;153:459-466.
Berenson J, Casciato DA. Plasma cell disorders. En: Casciato DA, Lowitz BB editores. Manual of clinical oncology. 4a. ed. Philadelphia, PA, USA: Lippincot Williams and Wilkins;2000. pp. 443-460.
Ruiz-Arguelles GJ, Cantú-Rodríguez OG, Mercado-Díaz L, Apreza-Molina G, Gómez-Almaguer D, Cortés-Franco J, Góngora-Biachi RA, Pizzuto J, Rodríguez-Carrillo J, Romero-García F, Torre-López E, Vázquez-Villegas V. Some chronic lymphoproliferative malignancies in México are less frequent than in Caucasian populations. Blood 1996;88(Suppl 1):217b.
Ruiz-Reyes G, Pérez-Romano B, Ruiz-Arguelles A. Immunologic classification of 323 monoclonal gammopathies in México. Rev Invest Clín Mex 1994;46(Supl 1):320.
Ruiz-Argüelles GJ, Ramírez-Cisneros FJ, Flores-Martínez J, CernudaGraham MC. Waldenströjm’s macroglobulinemia is infrequent in Mexican mestizos: Experience of a hematological diseases referal center. Rev Invest Clin Mex 2000;52:497-499.
Ruiz-Reyes G, Landero-de-Ruiz N, Armenta-Oivera T, Sánchez-Fernández M, Pérez-de-Sánchez CL, Gamboa-Ojeda J. Gamapatías monoclonales I. Distribuición de clases y tipos de cadenas pesadas y ligeras en 182 casos. Rev Invest Ciín Mex 1978;30:359-365.
Mailk AA, Ganti AK, Potti A, Levift R, Hanley JF. Role of Helicobacter pylori infection in the incidence and clinical course of monocional gammopathy of undetermined significance. Am J Gastroenterol 2002;97:1371-1374.
Tursi A, Modeo ME. Monoclonal gammopathy of undetermined significance predisposing to Helicobacter pylori-related gastric mucosa-associated lymphold tissue lymphoma. J Clin Gastroenterol 2002;34:147-149.
Payne DA, Chan TS, Ostermeyer T, Schoaib B, Patten BM, Tyring SK. Human papillomavirus is associated with monoclonal gammopathies of unknown significance. J Blomed Sci 1996;3:319-322.
Beksac M, Ma M, Akyeril C, DerDanlellan M, Zhang L, Liu J, Arat M, Konuk N, Koc H, Ozcellk T, Vescio R, Berenson JR. Frequent demonstration of human herpesvirus 8 (HHV-8) in bone marrow biopsy samples from Turkish patients with multiple myeloma (MM). Leukemia 2001;15:1268-1273.
Rajkumar SV, Mesa RA, Fonseca R, Schroeder G, Plevak MF, Dispenzieri A, Lacy MQ, Lust JA, Witzig TE, Gertz MA, Kyle RA, Russell SJ, Greipp PR. Bone marrow anglogenesis in 400 patients with monoclonal gammopathy of undetermined significance, multiple myeloma, and primary amyloidosis. Clin Cancer Res 2002;7:2210-2216.
Fonseca R, Aguayo P, Ahmann GJ, et al. Translocations at 14q32 are common in patients with the monoclonal gammopathy of undetermined significance (MGUS) and involve several partner chromosomes. Blood 1999;94(Suppl 1): 663a.
Rasillo A, Tabernero MD, Sánchez ML, Pérez-de-Andrés M, Martin-Ayuso M, Hernandez J, Moro MJ, Fernández-Calvo J, Sayagues JM, Bortoluci A, San Miguel JF, Orfao A. Fluorescence in situ hybridization analysis of aneuploidization patterns in monoclonal gammopathy of undetermined significance versus multiple myeloma and plasma cell leukemia. Cancer 2003;97:601-609.
Kyie RA,Therneau TM, Rajkumar SV, Offord J, Larson D, Plevak MF, Melton J. A long-term study of prognosis in monoclonal gammopathy of undetermined significance. N Engí J Med 2002;346:564-569.
Blade J, Filella X, Montoto S, Bosch F, Rosinol L, Coca F, Gine E, Nadal E, Aymerich M, Rozman M, Montserrat E. Interleukin 6 and tumour necrosis factor afpha serum levels in monoclonal gammopathy of undetermined significance. Br J Haematol 2002;117:387-389.
Fisher MA, Wilson JR. Characterizing neuropathies associated with monoclonal gammopathy of undetermined significance (MGUS): a framework consistent with classlfylng injuries according to fiber size. Neurol Clin Neurophysiol 2002;3:2-7.
Lamboley V, Zabranlecki L, Sie P, Pourrat J, Fournie B. Myeloma and monoclonal gammopathy of uncertain significance associated with acquired von Willebrand’s syndrome. Seven new cases with a literature review. Joint Bone Spine 2002;69:62-67.
Biadé-Creixenti J, San-Miguel JF. Gammapatías monoclonales. En: Farreras Valentí C, Rozman C, editores. Medicina Interna. 142ndo. Madrid, España: Harcourt;2000. pp. 1992-2001.
Ribatti D, Vacca A, De Falco G, Roccaro A, Roncali L, Dammacco F. Angiogenesis, anglogenic factor expression and hematological malignancies. Anticancer Res 2001;21:4333-339.
Gregersen H, Mellemkjaer L, Ibsen JS, Dahlerup JF, Thomassen L, Sorensen HT. The impact of M-component type and immunoglobulin concentration on the risk of malignant transformation in patients with monoclonal gammopathy of undetermined significance. Haematologica 2001;11:1172-1179.
Cesana C, Kiersy C, Barbarano L, Nosari AM, Crugnola M, Pungolino E, Gargantini L, Granata S, Valentini M, Morra E. Prognostic factors for malignant transformation in monoclonal gammopathy of undetermined significance and smoldering multiple myeloma. J Clin Oncol 2002;20:162534.