不确定意义的单克隆抗体病
医学
内科学
多发性骨髓瘤
淀粉样变性
糖基化
胃肠病学
队列
风险因素
淀粉样变性
单克隆
免疫球蛋白轻链
浆细胞失调
肿瘤科
免疫学
单克隆抗体
抗体
生物
生物化学
作者
Angela Dispenzieri,Dirk R. Larson,S. Vincent Rajkumar,Robert A. Kyle,Shaji Kumar,Taxiarchis Kourelis,Bonnie K. Arendt,Maria Willrcih,Surendra Dasari,David Murray
出处
期刊:Leukemia
[Springer Nature]
日期:2020-06-27
卷期号:34 (10): 2749-2753
被引量:41
标识
DOI:10.1038/s41375-020-0940-8
摘要
Our group previously demonstrated that M-protein light chain (LC) glycosylation can be detected on routine MASS-FIX testing. Glycosylation is increased in patients with immunoglobulin LC amyloidosis (AL) and rarely changes over the course of a patient’s lifetime. To determine the rates of progression to AL and other plasma cell disorders (PCDs), we used residual serum samples from the Olmsted monoclonal gammopathy of undetermined significance (MGUS) screening cohort. Four-hundred and fourteen patients with known MGUS were tested by MASS-FIX, and 25 (6%) were found to have glycosylated LCs. With a median follow-up of surviving patients of 22.2 years, the 20-year progression rates to a malignant PCD were 67% (95% CI 29%, 84%) and 13% (95% CI 9%, 18%) for patients with and without glycosylated LCs, respectively. The risk of progression was independent of Mayo MGUS risk score. The respective rates of progression to AL at 20 years were 21% (95% CI 0.0%, 38%) and 3% (95% CI 0.6%, 5.5%). In summary, monoclonal LC glycosylation is a potent risk factor for progression to AL, myeloma, and other PCDs, an observation which could lead to earlier diagnoses and potentially reduced morbidity and mortality.
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