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.
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Article Info
Footnotes
This study was partially supported by Nagasaki University 21st Century COE Program of the Ministry of Education, Culture, Sports, Science and Technology of Japan.
Identification
Copyright
© 2007 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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- Monoclonal Gammopathy of Undetermined Significance: Genetic vs Environmental EtiologiesMayo Clinic ProceedingsVol. 82Issue 12
- PreviewSince 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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