Journal
ANNALS OF HEMATOLOGY
Volume 97, Issue 8, Pages 1463-1469Publisher
SPRINGER
DOI: 10.1007/s00277-018-3305-x
Keywords
Light chain MGUS; Germany; Population-based; Cancer; Renal disease
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Funding
- Faculty of Medicine of the University Hospital of Essen (IFORES)
- Celgene, Munich, Germany
- Heinz Nixdorf Foundation
- Kulturstiftung Essen Germany
- German Research Council (DFG) [ER 155/6-2, SI 236/8-1, SI 236/9-1]
- German Ministry of Education and Science (BMBF)
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We determined the 10-year progression rate of light chain monoclonal gammopathy of undetermined significance (LCMGUS) and investigated potential associations with cancer utilizing the German population-based Heinz Nixdorf Recall Study. The Heinz Nixdorf Recall Study comprises 4814 men and women aged 45-75 years. Serum samples from baseline (2000-2003) and five-year (2006-2008) and 10-year (2011-2015) follow-up examinations were screened for monoclonal free light chains (FLC). LCMGUS was defined as abnormal FLC ratio, increase of involved FLC with complete loss of immunoglobulin heavy chain, and absence of a history of lymphoproliferative disease (LPD). Seventy-five individuals with LCMGUS were identified across all three evaluation time points (median age 64 years; 43 (57%) male; FLCR > 1.65 65 (87%); FLCR <= 0.65 10 (13%)). After a median observation time of 11.5 years, none of the LCMGUS cases had progressed to overt LPD; in particular, we did not observe incident light chain multiple myeloma. On serial analysis 17/31 (55%), LCMGUS could not be confirmed and disappearance of the monoclonal protein was associated with low concentrations of the involved FLC. Individuals with LCMGUS had a 1.5-fold increased risk of cancer but did not show differences in overall survival or renal function as compared to individuals with normal FLC. In conclusion, LCMGUS represents a relatively benign condition with a high disappearance rate of the monoclonal protein on longitudinal analysis and normal overall survival at least in the population-based setting.
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