BENIGN MONOCLONAL GAMMOPATHY - AFTER 20 TO 35 YEARS OF FOLLOW-UP
BENIGN MONOCLONAL GAMMOPATHY - AFTER 20 TO 35 YEARS OF FOLLOW-UP
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DOI：
10.1016/s0025-6196(12)60015-9
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发表时间：
1993-01-01
影响因子：
8.9
通讯作者：
KYLE, RA
中科院分区：
文献类型：
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作者：
KYLE, RA
所有241例在1971年1月1日前在梅奥诊所接受检查的明显良性的单克隆性丙种球蛋白病患者均接受了20~35年(中位数22年)的前瞻性随访。定期进行血清和尿液样本的电泳法和免疫电泳法，以确定多发性骨髓瘤、原发性淀粉样变性、巨球蛋白血症或其他淋巴增生性疾病的发生频率。随访时将患者分为四组：第一组(良性)-46例(19%)活着且有良性单克隆性丙种球蛋白病，第二组-23例(10%)血清单抗蛋白水平在3g/dl或以上但不需要化疗，第三组-113例(47%)死亡时没有骨髓瘤或相关疾病的证据，第三组-113例(47%)死亡，无骨髓瘤或相关疾病。4-59例(24%)，其中多发性骨髓瘤(39例)、系统性淀粉样变性(8例)、巨球蛋白血症(7例)、恶性淋巴增生性疾病(5例)在检测到单抗蛋白后的中位数分别为10年、9年、8年和10年半。因此，在明显良性的单克隆性丙种球蛋白病患者中，必须无限期地继续随访，因为大约四分之一的患者会出现多发性骨髓瘤、淀粉样变性、巨球蛋白血症或相关疾病。
All 241 patients with an apparently benign monoclonal gammopathy who were examined at the Mayo Clinic before Jan. 1, 1971, underwent prospective follow-up for 20 to 35 years (median, 22 years). Electrophoresis and immunoelectrophoresis of serum and urine specimens were performed periodically in an effort to determine the frequency of development of multiple myeloma, primary amyloidosis, macroglobulinemia, or other lymphoproliferative diseases. At follow-up, the patients were categorized into one of four groups: group 1 (benign)-46 patients (19%) who were alive and had a benign monoclonal gammopathy; group 2-23 patients (10%) who had a serum monoclonal protein value of 3 g/dl or more but did not require chemotherapy; group 3-113 patients (47%) who died without evidence of myeloma or related disorders; and group 4-59 patients (24%) in whom multiple myeloma (39), systemic amyloidosis (8), macroglobulinemia (7), or a malignant lymphoproliferative disease (5) developed at a median of 10, 9, 8, and 10 1/2 years, respectively, after detection of the monoclonal protein. Thus, in patients with an apparently benign monoclonal gammopathy, follow-up must be continued indefinitely because multiple myeloma, amyloidosis, macroglobulinemia, or related disorders occur in approximately a fourth of them.