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Prevalence of Monoclonal Gammopathy of Undetermined Significance: Study of 52,802 Persons in Nagasaki City, Japan

      OBJECTIVE

      To assess the prevalence of monoclonal gammopathy of undetermined significance (MGUS) in a large Japanese population.

      PARTICIPANTS AND METHODS

      From October 1, 1988, to March 31, 2004, a total of 52,802 (of 71,675) Japanese survivors of the atomic bomb explosion in Nagasaki City, Japan, were screened for M protein. The youngest participant was 42.3 years as of October 1, 1988. A 2-step screening was performed with a serum protein electrophoresis followed by immunoelectrophoresis and a quantitative determination of serum concentration of immunoglobulins. Twenty-one patients who were diagnosed for the first time at the time of screening as having multiple myeloma and Waldenström macroglobulinemia were excluded from analyses. Age- and sex-specific prevalence rates of MGUS were calculated.

      RESULTS

      Monoclonal gammopathy of undetermined significance was identified in 1088 of the 52,781 study participants. The overall prevalence of MGUS was 2.1% (95% confidence interval [CI], 1.9%-2.2%) in the total population screened and 2.4% (95% CI, 2.0%-2.6%) in those 50 years or older. The prevalence was significantly higher in men than in women (2.8% vs 1.6%; age-adjusted odds ratio, 2.0; 95% CI, 1.8-2.3; P<.001). In both sexes, the prevalence rose with increasing age from 1.0% in participants aged 42 to 49 years, 1.9% in those 50 to 59 years, 2.6% in those 60 to 69 years, and 3.0% in those 70 to 79 years, to 4.4% in those 80 years and older. The heavy chain isotypes of immunoglobulin were IgG in 73.6% of patients, IgA in 17.7%, IgM in 7.5%, and oligoclonal gammopathies in 1.1%.

      CONCLUSION

      The prevalence of MGUS is lower in this Japanese population than that reported in Western countries among people older than 60 years, especially among women.
      CI (confidence interval), MGUS (monoclonal gammopathy of undetermined significance), MM (multiple myeloma), WM (Waldenström macroglobulinemia)
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      Linked Article

      • Monoclonal Gammopathy of Undetermined Significance: Genetic vs Environmental Etiologies
        Mayo Clinic ProceedingsVol. 82Issue 12
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          Since its first description in 1978,1 monoclonal gammopathy of undetermined significance (MGUS) has remained an enigmatic clinical entity as a precursor to development of multiple myeloma (MM). Its progression to MM occurs at a constant rate of 1% per year, and the rate does not change with time. In most patients, MGUS does not progress to MM, requiring no therapeutic intervention. Presence of non-IgG M protein, serum M component greater than 1.5 g/dL, and an abnormal free light chain ratio predicts progression of MGUS to MM.
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