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Xu A, Guo T, Zhang S, Luo H, Shen M, Ye Y, Ji L. Prevalence of monoclonal gammopathy of undetermined significance in Shenzhen, China. Hematology 2024; 29:2352686. [PMID: 38819332 DOI: 10.1080/16078454.2024.2352686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/03/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Data on the prevalence of monoclonal gammopathy of undetermined significance (MGUS) in China are very limited. Our aim was to determine the prevalence and clinical characteristics of MGUS in a large Chinese population. METHODS This study included 49,220 healthy people who received serum immunofixation electrophoresis (sIFE) and serum protein electrophoresis (SPE) tests. Serum free light chain ratio, immunoglobulin quantification, and other clinically correlates of MGUS were performed for all patients with M-protein. RESULTS A total of 576 MGUS patients were identified by sIFE, with a median age of 58 years and an overall prevalence of 1.17% (95% CI, 1.08-1.27). Among those aged 50 years and older, the prevalence of MGUS was 2.26% (95% CI, 2.04-2.50). The prevalence of MGUS was significantly higher in males than in females (P < 0.05). The median concentration of M-protein was 3.1 g/L, ranging from 0.5 g/L to 25.1 g/L. The M-protein type was IgG in 55.4% of MGUS patients, followed by IgA (31.1%), IgM (9.5%), IgD (0.5%), biclonal (2.3%), and light chain (1.2%). Abnormalities in SPE, FLC ratios, and immunoglobulin levels were observed in 78.3%, 31.1%, and 38.4% of MGUS patients, respectively. CONCLUSIONS The prevalence of MGUS is substantially lower in southern China than in whites and blacks.
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Affiliation(s)
- Anping Xu
- Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China
| | - Tong Guo
- Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China
| | - Shuping Zhang
- Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China
| | - Houlong Luo
- Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China
| | - Mengxue Shen
- Department of Laboratory Medicine, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Yinghui Ye
- Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China
| | - Ling Ji
- Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China
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Saeidi V, Garimella V, Shaji K, Wetter DA, Davis MDP, Todd A, Dutz J, Alavi A. Monoclonal gammopathy in the setting of Pyoderma gangrenosum. Arch Dermatol Res 2024; 316:268. [PMID: 38795175 DOI: 10.1007/s00403-024-03098-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 03/28/2024] [Accepted: 04/26/2024] [Indexed: 05/27/2024]
Abstract
Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterized by ulcerative painful lesions with violaceous undermined borders. Up to 75% of PG cases develop in association with an underlying systemic disease. Monoclonal gammopathy is reportedly a concomitant condition with PG, with studies indicating immunoglobulin (Ig) A gammopathy as the most common. Whether gammopathy is associated with PG or is an incidental finding has been debated. We sought to investigate the association and characteristics of gammopathy in patients with PG. We retrospectively identified PG patients at our institution from 2010 to 2022 who were screened for plasma cell dyscrasia. Of 106 patients identified, 29 (27%) had a gammopathy; subtypes included IgA (41%), IgG (28%), and biclonal (IgA and IgG) (14%). Mean age was similar between those with and without gammopathy (60.7 vs. 55.9 years; P = .26). In addition, hematologic or solid organ cancer developed in significantly more patients with vs. without gammopathy (8/29 [28%] vs. 5/77 [6%]; P = .003). Among the subtypes of gammopathy, IgG monoclonal gammopathy had the highest proportion of patients with subsequent cancer development (4 of 8 patients, 50%). Study limitations include a retrospective, single-institution design with a limited number of patients. Overall, our data show a high prevalence of gammopathy in patients with PG; those patients additionally had an increased incidence of cancer, especially hematologic cancer.
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Affiliation(s)
- Vahide Saeidi
- Department of Dermatology, Mayo Clinic, Rochester, MN, Canada
| | | | - Kumar Shaji
- Department of Hematology, Mayo Clinic, Rochester, MN, USA
| | - David A Wetter
- Department of Dermatology, Mayo Clinic, Rochester, MN, Canada
| | | | - Austin Todd
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Jan Dutz
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, Canada.
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Abeykoon JP, Tawfiq RK, Kumar S, Ansell SM. Monoclonal gammopathy of undetermined significance: evaluation, risk assessment, management, and beyond. Fac Rev 2022; 11:34. [PMID: 36532706 PMCID: PMC9720897 DOI: 10.12703/r/11-34] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023] Open
Abstract
Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant state for a spectrum of lymphoplasmacytic malignancies. The risk of progression of MGUS to a symptomatic therapy requiring plasma cell dyscrasia is about 1% per year. Studies carried out over the previous 10 years have improved risk stratification of MGUS based on serologic and genomic evaluations, which has led to better management of patients. In this review, we address the epidemiology, diagnosis, and pathogenesis of MGUS and discuss risk-adapted best practice approaches to monitor patients.
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Affiliation(s)
- Jithma P Abeykoon
- Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Reema K Tawfiq
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Shaji Kumar
- Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Stephen M Ansell
- Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Hofmann JN, Beane Freeman LE, Murata K, Andreotti G, Shearer JJ, Thoren K, Ramanathan L, Parks CG, Koutros S, Lerro CC, Liu D, Rothman N, Lynch CF, Graubard BI, Sandler DP, Alavanja MC, Landgren O. Lifetime Pesticide Use and Monoclonal Gammopathy of Undetermined Significance in a Prospective Cohort of Male Farmers. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:17003. [PMID: 33404262 PMCID: PMC7787072 DOI: 10.1289/ehp6960] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 11/06/2020] [Accepted: 12/04/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND Farmers have a higher incidence of multiple myeloma, and there is suggestive evidence of an elevated prevalence of its precursor, monoclonal gammopathy of undetermined significance (MGUS), relative to the general population. Pesticide exposures are suspected to play a role; however, the biologic plausibility for associations with multiple myeloma remains unclear. OBJECTIVES Our objectives were to examine the prevalence of MGUS and evaluate associations with a wide range of pesticides in a large sample of farmers. METHODS We obtained sera and assessed MGUS among 1,638 male farmers ≥ 50 years of age in the Agricultural Health Study (AHS), a prospective cohort in Iowa and North Carolina. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed to estimate associations with MGUS for recent use (within the 12 months before phlebotomy) and cumulative intensity-weighted lifetime days of use of specific pesticides. RESULTS The age-standardized MGUS prevalence was significantly elevated among AHS farmers (7.7%) compared with demographically similar men in the National Health and Nutrition Examination Survey (2.8%) or Olmsted County, Minnesota (3.8%; p < 0.001 ). Recent use of permethrin was associated with MGUS [recent use vs. no recent use, OR = 1.82 (95% CI: 1.06, 3.13)], especially among those who had also used it in the past [recent and past use vs. never use, OR = 2.49 (95% CI: 1.32, 4.69)]. High intensity-weighted lifetime use of the organochlorine insecticides aldrin and dieldrin was associated with MGUS relative to those who never used either of these pesticides [OR = 2.42 (95% CI: 1.29, 4.54); p trend = 0.006 ]. We also observed a positive association with high lifetime use of petroleum oil/distillates as an herbicide, as well as an inverse association with fonofos use. DISCUSSION This is the largest investigation of MGUS in farmers and the first to identify an association with MGUS for permethrin, a pyrethroid insecticide previously associated with multiple myeloma. Given the continued widespread use of permethrin in various residential and commercial settings, our findings may have important implications for exposed individuals in the general population. https://doi.org/10.1289/EHP6960.
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Affiliation(s)
- Jonathan N. Hofmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Laura E. Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Kazunori Murata
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Gabriella Andreotti
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Joseph J. Shearer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Katie Thoren
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lakshmi Ramanathan
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Christine G. Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, North Carolina, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Catherine C. Lerro
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Danping Liu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Charles F. Lynch
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Barry I. Graubard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, North Carolina, USA
| | - Michael C. Alavanja
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Ola Landgren
- Myeloma Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Myeloma Program, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida, USA
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Busson A, Gac AC, Gruson B, Meryet-Figuière M, Baldi I, Tual S, Lebailly P. Agriculture et hémopathies malignes chez l’adulte. Med Sci (Paris) 2020; 36 Hors série n° 1:16-22. [DOI: 10.1051/medsci/2020190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Han JH, Wang JN, Zhang YL, Cao XX, Zhou DB, Xu TD, Su W, Li J. Prevalence of monoclonal gammopathy of undetermined significance in a large population with annual medical check-ups in China. Blood Cancer J 2020; 10:34. [PMID: 32152278 PMCID: PMC7062721 DOI: 10.1038/s41408-020-0303-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/17/2020] [Accepted: 02/27/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- Jian-Hua Han
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ji-Nuo Wang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue-Lun Zhang
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin-Xin Cao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dao-Bin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Teng-da Xu
- Department of Health Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Wei Su
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Jian Li
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Ouyang W, Zhao X, Lu S, Wang Z. Prevalence of monoclonal gammopathy of uncertain significance in chronic myeloid leukemia: A case report. Medicine (Baltimore) 2018; 97:e13103. [PMID: 30383696 PMCID: PMC6221681 DOI: 10.1097/md.0000000000013103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE The abnormal cell types in chronic myeloid leukemia (CML) and monoclonal gammopathy of uncertain (MGUS) are quite different, being myeloid and plasma cells, respectively. The coexistence of CML and MGUS is an uncommon event, which is seldom reported in literature. PATIENT CONCERNS A 52-year-old female was diagnosed with CML in April 2001. From November 2006, the patient started on imatinib mesylate and kept a complete hematologic and cytogenetic response for nearly 11 years. During her follow-up on July 7, 2017, thrombocytopenia (35*109/L) was found. Bone marrow aspiration revealed 6% plasma cell infiltration. Serum immunoelectrophoresis revealed 1.24 g/dL of serum monoclonal (M) protein of IgG-κ type. DIAGNOSIS MGUS was diagnosed because of absence of anemia, hypercalcemia, lytic bone lesions, or renal failure. Immune thrombocytopenia (ITP) was also diagnosed in this patient following the detection of antiplatelet autoantibodies. Complex karyotype and missense mutation in PRDM1 were identified. INTERVENTIONS Because of her obvious decrease of platelets, she started treatment with thalidomide and prednisone. OUTCOMES Three months later, bone marrow aspirate showed disappearance of plasma cells. There developed an abrupt decrease in IgG and the absence of M-spike in serum immunoelectrophoresis. The platelet count kept normal during 1 year follow-up. LESSONS Karyotypic event and gene mutation found in this case may be the initiation of disease transformation. Administration of thalidomide and prednisone proved effective in this patient.
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Lemarchand C, Tual S, Levêque-Morlais N, Perrier S, Belot A, Velten M, Guizard AV, Marcotullio E, Monnereau A, Clin B, Baldi I, Lebailly P. Cancer incidence in the AGRICAN cohort study (2005-2011). Cancer Epidemiol 2017; 49:175-185. [PMID: 28709062 PMCID: PMC6200131 DOI: 10.1016/j.canep.2017.06.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/22/2017] [Accepted: 06/06/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Numerous studies have been conducted among farmers, but very few of them have involved large prospective cohorts, and few have included a significant proportion of women and farm workers. Our aim was to compare cancer incidence in the cohort (overall, by sex, and by work on farm, occupational status and pesticide use) within the general population. METHODS More than 180,000 participants in the AGRICAN cohort were matched to cancer registries to identify cancer cases diagnosed from enrolment (2005-2007) to 31st December 2011. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (95%CIs). RESULTS Over the period, 11,067 incident cancer cases were identified (7304 men and 3763 women). Overall cancer incidence did not differ between the cohort and the general population. Moreover, SIRs were significantly higher for prostate cancer (SIR=1.07, 95%CI 1.03-1.11) and non-Hodgkin lymphoma (SIR=1.09, 95%CI 1.01-1.18) among men, skin melanoma among women (SIR=1.23, 95%CI 1.05-1.43) and multiple myeloma (men: SIR=1.38, 95%CI 1.18-1.62; women: SIR=1.26, 95%CI 1.02-1.54). In contrast, SIRs were lower for upper aerodigestive tract and respiratory cancers. Increase in risk was greater in male farm workers for prostate and lip cancer, in female farm workers for skin melanoma, and in male farm owners for multiple myeloma. Moreover, incidence of multiple myeloma and skin melanoma was higher among male and female pesticide users respectively. CONCLUSION We found a decreased incidence for tobacco-related cancers and an increased incidence of prostate cancers, skin melanoma and multiple myeloma. Specific subgroups had a higher cancer incidence related to occupational status and pesticide use.
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Affiliation(s)
- Clémentine Lemarchand
- INSERM, UMR 1086 Cancers et Préventions, F-14076, Caen, France; Université de Caen Normandie, F-14032, Caen, France; Centre de Lutte Contre le Cancer François Baclesse, F-14076, Caen, France.
| | - Séverine Tual
- INSERM, UMR 1086 Cancers et Préventions, F-14076, Caen, France; Université de Caen Normandie, F-14032, Caen, France; Centre de Lutte Contre le Cancer François Baclesse, F-14076, Caen, France
| | - Noémie Levêque-Morlais
- INSERM, UMR 1086 Cancers et Préventions, F-14076, Caen, France; Université de Caen Normandie, F-14032, Caen, France; Centre de Lutte Contre le Cancer François Baclesse, F-14076, Caen, France
| | - Stéphanie Perrier
- INSERM, UMR 1086 Cancers et Préventions, F-14076, Caen, France; Université de Caen Normandie, F-14032, Caen, France; Centre de Lutte Contre le Cancer François Baclesse, F-14076, Caen, France
| | - Aurélien Belot
- Hospices Civils de Lyon, Service de Biostatistique, F-69003, Lyon, France
| | - Michel Velten
- Registre des Cancers du Bas-Rhin, Faculté de Médecine, Université de Strasbourg, F-67085, Strasbourg, France
| | - Anne-Valérie Guizard
- INSERM, UMR 1086 Cancers et Préventions, F-14076, Caen, France; Registre Général des Tumeurs du Calvados, Centre François Baclesse, F-14076, Caen, France
| | - Elisabeth Marcotullio
- Caisse Centrale de la Mutualité Sociale Agricole, Direction de la santé sécurité au travail, F-93547, Bagnolet, France
| | - Alain Monnereau
- Registre des hémopathies malignes de la Gironde, F-33076, Bordeaux, France; INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health Center, EPICENE team, F-33076, Bordeaux, France; Université de Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health Center, EPICENE Team, F-33000, Bordeaux, France
| | - Bénédicte Clin
- INSERM, UMR 1086 Cancers et Préventions, F-14076, Caen, France; Université de Caen Normandie, F-14032, Caen, France; CHU de Caen, Service de Pathologie Professionnelle, F-14033, Caen, France
| | - Isabelle Baldi
- INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health Center, EPICENE team, F-33076, Bordeaux, France; Service de Médecine du Travail et Pathologies professionnelles, CHU de Bordeaux, F-33000, Bordeaux, France; Université de Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health Center, EPICENE Team, F-33000, Bordeaux, France
| | - Pierre Lebailly
- INSERM, UMR 1086 Cancers et Préventions, F-14076, Caen, France; Université de Caen Normandie, F-14032, Caen, France; Centre de Lutte Contre le Cancer François Baclesse, F-14076, Caen, France
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