Clinical characteristics and factors predicting evolution of asymptomatic IgM monoclonal gammopathies and IgM-related disorders

E. Morra, C. Cesana, C. Klersy, L. Barbarano, M. Varettoni, L. Cavanna, B. Canesi, E. Tresoldi, S. Miqueleiz, P. Bernuzzi, A. M. Nosari, M. Lazzarino

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Abstract

We evaluated the prognostic features of 384 asymptomatic IgM-monoclonal gammopathies; (aIgM-MGs) and 74 IgM-related disorders (IgM-RDs), two clinically distinct groups as proposed by the Second International Workshop on Waldenström's Macroglobulinemia (WM). The cumulative probability of evolution to lymphoid malignancy at 5 and 10 years was 8% (95% CI, 5-13%) and 29% (95% CI, 21-38%), respectively, in aIgM-MGs; it was 9% (95% CI, 4-20%) and 16% (95% CI, 7-31%), respectively, in IgM-RDs (P=0.26). At a median follow-up of 45 months (12-233), 45 aIgM-MGs (11.7%) evolved to symptomatic WM (n= 41), non-Hodgkin's lymphoma (NHL) (n=2), IgM multiple myeloma (n=1), and primary amyloidosis (n=1). At a median follow-up of 60 months (13-195), seven IgM-RDs (9.5%) evolved to symptomatic WM (n=6), and B-chronic lymphocytic leukaemia (n=1). At univariate analysis, in aIgM-MGs bone marrow lymphoplasmacytic infiltration, high erythrocyte sedimentation rate (ESR), haemoglobin level, IgM size, and lymphocytosis significantly correlated with evolution probability. At multivariate analysis, the latter two parameters strongly correlated with prognosis, haemoglobin being associated with a trend for a higher progression risk. In IgM-RDs IgM size, neutropenia, lymphocytosis, detectable Bence Jones proteinuria, and high ESR were associated with evolution probability. In conclusion, asymptomatic IgM-MGs and IgM-RDs are distinct clinical entities with similar probability of transformation to lymphoid malignancy.

Original languageEnglish
Pages (from-to)1512-1517
Number of pages6
JournalLeukemia
Volume18
Issue number9
DOIs
Publication statusPublished - Sep 2004

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Keywords

  • IgM monoclonal gammopathy
  • IgM-related disorders
  • Malignant transformation
  • Prognostic factors
  • Smouldering WM
  • Waldenström's macroglobulinemia (WM)

ASJC Scopus subject areas

  • Cancer Research
  • Hematology

Cite this

Morra, E., Cesana, C., Klersy, C., Barbarano, L., Varettoni, M., Cavanna, L., Canesi, B., Tresoldi, E., Miqueleiz, S., Bernuzzi, P., Nosari, A. M., & Lazzarino, M. (2004). Clinical characteristics and factors predicting evolution of asymptomatic IgM monoclonal gammopathies and IgM-related disorders. Leukemia, 18(9), 1512-1517. https://doi.org/10.1038/sj.leu.2403442