Prevalence and type of monoclonal gammopathy of undetermined significance in an apparently healthy Nigerian population: a cross sectional study

BMC Hematology

Alani S Akanmu²  Sarah O Ajibola³  Adewumi Adediran²  Titilope A Adeyemo²  A Lawretta Onwah¹ 

[1] Department of Pathology, Federal Medical Centre, Abeokuta, Nigeria;Department of Haematology & Blood Transfusion, Faculty of Clinical Sciences, College of Medicine, University of Lagos, P.M.B. 12003, Marina, Lagos, Nigeria;Department of Haematology & Blood Transfusion, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria

关键词: Lagos;    Gammopathy;    Monoclonal;    Type;    Prevalence;   

Others  :  865395
DOI  :  10.1186/1471-2326-12-7

 received in 2012-01-11, accepted in 2012-06-21,  发布年份 2012

【 摘 要 】

Background

The prevalence of monoclonal gammopathy of undetermined significance (MGUS), a premalignant plasma-cell disorder has not been determined in our geographic area Nigeria.

Methods

A cross sectional survey was carried on apparently healthy Nigerians selected by multistage sampling technique from the cosmopolitan city of Lagos, Nigeria. Subjects enrolled into the study had 2-step screening for the presence, type and concentration of monoclonal band. Agarose-gel electrophoresis was performed on all serum samples, and any serum sample with a discrete band of monoclonal protein or thought to have a localized band was subjected to Immunofixation. Subjects were also evaluated for Bence jones proteinuria, haematological and biochemical parameters.

Results

Four hundred and ten subjects with a mean age of 45.68 ± 10.3 years, a median of 45.00 years and a range of 20 to 80 years were enrolled into the study. MGUS was identified in only one (0.24 percent) of the 410 study subject. This subject was demonstrated to have a double monoclonal gammopathy; IgGλ at 16.9 g/L and IgAκ at 8.5 g/L. None of them including the sole subject with MGUS had a monoclonal urinary light chain.

Conclusion

Among residents of Lagos, Nigeria, MGUS was found in only 0.24% percent of apparently normal persons with a median age of 45 years. This suggests that MGUS which represents the earliest stage of monoclonal plasma/lymphoid cell proliferation is not a common finding in the relatively young population of Nigeria. Future epidemiologic studies dealing with plasma cell disorders in older people are required to carefully examine the relationship between environmental factors and prevalence of MGUS and its ultimate progression to MM.

【 授权许可】

   
2012 Onwah et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Kyle RA, Therneau TM, Rajkumar SV, et al.: A long term study of prognosis in Monoclonal gammopathy of undetermined significance. N Engl J Med 2002, 346:564-569.
• [2]Marshall AL: Essential Monoclonal gammopathy. In Williams Haematology. 6th edition. Edited by Ernest B, Lichtman MA, Coller BS, Kipps TJ, Uri S. McGraw-Hill, New York; 2001:1271-1277.
• [3]Criteria for the classification of monoclonal gammopathies: Multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol 2003, 121:749-757.
• [4]Kyle RA, Rajkumar SV: Monoclonal gammopathies of undetermined significance: a review. Immunol Rev 2003, 194:112-139.
• [5]Kyle RA, Therneau TM, Rajkumar SV, Larson DR, Plevak MF, Melton LJ III: Long-term follow-up of 241 patients with monoclonal gammopathy of undetermined significance: the original Mayo Clinic series 25 years later. Mayo Clin Proc 2004, 79:859.
• [6]Kyle RA, Therneau TM, Rajkumar SV, Larson DR, Plevak MF, Offord JR, et al.: Prevalence of monoclonal gammopathy of undetermined significance. N Engl J Med 2006, 354:1362-1369.
• [7]Kyle RA, Therneau TM, Melton LJ III, Dispenzieri A, Larson D, Benson J, et al.: Monoclonal gammopathy of undetermined significance: estimated incidence and duration prior to recognition. Blood 2007, 110:79a. Abstract #246
• [8]Cohen HJ, Crawford J, Rao MK, Pieper CF, Currie MS: Racial differences in the prevalence of monoclonal gammopathy in a community-based sample of the elderly.[erratum in Am J Med 1998;105:362]. Am J Med 1998, 104:439-444.
• [9]Singh J, Dudley AW Jr, Kulig KA: Increased incidence of monoclonal gammopathy of undetermined significance in blacks and its age-related differences with whites on the basis of a study of 397 men and one woman in a hospital setting. J Lab Clin Med 1990, 116:785-789.
• [10]Landgren O, Katzmann JA, Hsing AW, Pfeiffer RM, Kyle RA, Yeboah ED, et al.: Prevalence of monoclonal gammopathy of undetermined significance among men in Ghana. Mayo Clin Proc 2007, 82:1468-1473.
• [11]Iwanaga M, Tagawa M, Tsukasaki K, Kamihira S, Tomonaga M: Prevalence of monoclonal gammopathy of undetermined significance: study of 52,802 persons in Nagasaki City, Japan. Mayo Clin Proc 2007, 82:1474-1479.
• [12]Wadhera RK, Rajkumar SV: Prevalence of monoclonal gammopathy of undetermined significance: a systematic review. Mayo Clin Proc 2010, 85(10):933-942.
• [13]Araoye MO: Subject Selection. First Edition edition. Nathadex publishers, Ilorin; 2003:115-129. [Research Methodology with Statistic for Health and Social Sciences]
• [14]Axelsson U, Bachmann R, Hallen J: Frequency of pathological proteins (M-components) in 6,995 sera from an adult population. Acta Med Scand 1966, 179:235-247.
• [15]Landgren O, Gridley G, Turesson I: Risk of monoclonal gammopathy of undetermined significance (MGUS) and subsequent multiple myeloma among African American and white veterans in the United states. Blood 2006, 107(3):904-906.
• [16]Iwanaga M, Tagawa M, Tsukasaki K, Matsuo T, Yokota K, Miyazaki Y, et al.: Relationship between monoclonal gammopathy of undetermined significance and radiation exposure in Nagasaki atomic bomb survivors. Blood 2009, 113(8):1639-1650.
• [17]Landgren O, Kyle RA, Hoppin JA, Beane Freeman LE, Cerhan JR, Katzmann JA, Rajkumar SV, Alavanja MC: Pesticide exposure and risk of monoclonal gammopathy of undetermined significance in the Agricultural Health Study. Blood 2009, 18;113(25):6386-6391.
• [18]Vachon CM, Kyle RA, Therneau TM, Foreman BJ, Larson DR, Colby CL, et al.: Increased risk of monoclonal gammopathy in first-degree relatives of patients with multiple myeloma or monoclonal gammopathy of undetermined significance. Blood 2009, 114:785-790.
• [19]Landgren O, Kyle RA, Pfeiffer RM, Katzmann JA, Caporaso NE, Hayes RB, et al.: Monoclonal gammopathy of undetermined significance (MGUS) consistently precedes multiple myeloma: a prospective study. Blood 2009, 113:5412-5417.
• [20]Weiss BM, Abadie J, Verma P, Howard RS, Kuehl WM: A Monoclonal Gammopathy precedes multiple myeloma in most patients. Blood 2009, 113:5418-5422.
• [21]Kristinsson SY, Bjorkholm M, Andersson TM, Eloranta S, Dickman PW, Goldin LR, et al.: Patterns of survival and causes of death following a diagnosis of monoclonal gammopathy of undetermined significance: a population-based study. Haematologica 2009, 94:1714-1720.