Predictive variables for malignant transformation in 452 patients with asymptomatic IgM monoclonal gammopathy

Enrica Morra, Clara Cesana, Catherine Klersy, Marzia Varettoni, Luigi Cavanna, Bianca Canesi, Elisabetta Tresoldi, Luciana Barbarano, Mario Lazzarino

Research output: Contribution to journalArticle

Abstract

The natural history of asymptomatic IgM monoclonal gammopathies (MG) and variables predicting evolution to symptomatic lymphoproliferative disorders were investigated in 452 patients diagnosed from 1975 to 2001. Univariate and multivariate Cox models were used to identify possible predictors of disease progression. At a median follow-up of 49 months (range, 12 to 233), 41 cases (9.1%) evolved to symptomatic Waldenstrom's macroglobulinemia (n = 36), non-Hodgkin's lymphoma (n = 2), B-cell chronic lymphocytic leukemia (n = 1), IgM multiple myeloma (n = 1), and primary amyloidosis (n = 1); the median interval from diagnosis was 53 months (range, 12 to 154). The cumulative probabilities of transformation into a symptomatic lymphoproliferative disease at 5 and 10 years were 8% (95% confidence interval [CI], 6% to 12%) and 21% (95% CI, 16% to 29%), respectively. At univariate analysis, monoclonal component size and hemoglobin level as continuous parameters, lymphocytosis (>4 × 109/L), bone marrow lymphoplasmacytoid infiltration (>10%), erythrocyte sedimentation rate (>40 mm/h), and detectable Bence Jones proteinuria were significantly related with evolution probability. At multivariate analysis, paraprotein level (P <.0001), hemoglobin level (P <.05), and lymphocytosis (P <.0001) independently predicted malignant evolution (P <.0001). In conclusion, patients with asymptomatic IgM-MG showing hematological features predictive of progression should be carefully monitored in view of an early treatment of the disease.

Original languageEnglish
Pages (from-to)172-177
Number of pages6
JournalSeminars in Oncology
Volume30
Issue number2
DOIs
Publication statusPublished - Apr 2003

ASJC Scopus subject areas

  • Oncology

Fingerprint Dive into the research topics of 'Predictive variables for malignant transformation in 452 patients with asymptomatic IgM monoclonal gammopathy'. Together they form a unique fingerprint.

  • Cite this