Received from the International Myeloma Foundation
March 30, 2006
New England Journal of Medicine, Volume 354:1362-1369, Number 13
Prevalence of
Monoclonal Gammopathy of Undetermined Significance
Robert
A. Kyle, M.D., Terry M. Therneau, Ph.D., S. Vincent Rajkumar, M.D.,
Dirk R. Larson, M.S., Matthew F. Plevak, B.S., Janice R. Offord, B.S.,
Angela Dispenzieri, M.D., Jerry A. Katzmann, Ph.D., and L. Joseph
Melton, III, M.D.
ABSTRACT
Background
The prevalence of monoclonal gammopathy of undetermined
significance (MGUS), a premalignant plasma-cell disorder,
among persons 50 years of age or older has not been
accurately determined. We used sensitive laboratory
techniques to ascertain the prevalence of MGUS in a
large population in a well-defined geographic area.
Methods We identified all living residents
of Olmsted County, Minnesota, as of January 1,
1995. We obtained serum that remained after the
performance of routine clinical tests at Mayo Clinic
or asked subjects for whom such serum was unavailable to
provide a sample. Agarose-gel electrophoresis was
performed on all serum samples, and any serum
sample with a discrete band of monoclonal protein
or thought to have a localized band was subjected to
immunofixation.
Results Serum samples were obtained from
21,463 of the 28,038 enumerated residents 50 years
of age or older (76.6 percent). MGUS was identified
in 694 (3.2 percent) of these persons. Age-adjusted
rates were higher in men than in women (4.0 percent vs.
2.7 percent, P<0.001). The prevalence of MGUS was
5.3 percent among persons 70 years of age or older
and 7.5 percent among those 85 years of age or
older. The concentration of monoclonal
immunoglobulin was less than 1.0 g per deciliter in 63.5
percent and at least 2.0 g per deciliter in only
4.5 percent of 694 persons. The concentration of
uninvolved immunoglobulins was reduced in 27.7
percent of 447 persons tested, and 21.5 percent of
79 tested had a monoclonal urinary light chain.
Conclusions Among residents of Olmsted
County, Minnesota, MGUS was found in 3.2 percent of
persons 50 years of age or older and 5.3 percent of
persons 70 years of age or older.
Source Information
From the Divisions of Hematology
(R.A.K., S.V.R., A.D.), Biostatistics (T.M.T., D.R.L., M.F.P.,
J.R.O.), Clinical Biochemistry and Immunology (J.A.K.), and
Epidemiology (L.J.M.), Mayo Clinic, Rochester, Minn.
Address reprint requests to Dr. Kyle at the Division of Hematology,
Mayo Clinic, 200 First St. SW, Rochester, MN 55905, or at
kyle.robert@mayo.edu.
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