Long-term Follow-up of 241 Patients With Monoclonal Gammopathy of Undetermined Significance: The Original Mayo Clinic Series 25 Years Later

Kyle, Robert A.; Therneau, Terry M.; Rajkumar, S. Vincent; Larson, Dirk R.; Plevak, Matthew F.; Melton III, L. Joseph
July 2004
Mayo Clinic Proceedings;Jul2004, Vol. 79 Issue 7, p859
Academic Journal
Objective: To determine the long-term outcome of patients with monoclonal gammography of undetermined significance (MGUs). Patients and methods: We reviewed the medical records of 241 patients with MGUs who were examined at the Mayo Clinic in Rochester, Minn. between January 1, 1956, and December 31, 1970. Results: Follow-up was 3579 person-years (median, 13.7 years; range, 0-39 years). Only 14 patients (6%) were alive and had no substantial increase of M protein at last follow-up; 138 patients (57%) died without evidence of multiple myeloma or a related disorder; a malignant lymphoplasma cell proliferative disorder developed in 64 patients (27%). The interval from diagnosis of MGUs to diagnosis of multiple myeloma or related disorder ranged from 1 to 32 years (median, 10.4 years). Conclusions: The median survival rate of study patients with MGUs was only slightly shorter than that of a comparable US population. Risk of progression of MGUs to lymphoplasma cell malignancy is indefinite and persists even after more than 30 years of follow-up, with no reliable predictors of malignant evolution.


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