Seguimiento de una cohorte de pacientes con gammapatía monoclonal sérica en el Área Sanitaria de Guadalajara / Follow up of serum monoclonal gammopathy at Guadalajar health area

Objetivo: Conocer la evolución clínica de los pacientes del Área Sanitaria de Guadalajara en los que fue diagnosticada una paraproteína sérica. Material y métodos: Estudio prospectivo de 186 pacientes en los que durante los años 1999 y 2000 se detectó “de novo” una banda monoclonal sérica. Resultados: La probabilidad acumulada de progresión a enfermedad maligna fue del 4,99% a los 43 meses en los pacientes cuya paraproteína fue clínicamente soslayada y 2% a los 23 meses en pacientes diagnosticados de gammapatía monoclonal de significado incierto. La probabilidad acumulada de supervivencia en los pacientes con mieloma múltiple fue 66,7% a los 21 meses. La tasa condicionada de mortalidad (paciente/mes) a los 4 años debido a enfermedad hematológica fue de 4,48.10-4 en pacientes clínicamente soslayados, 0 en los diagnosticados de gammapatía monoclonal de significado incierto y 1,388.10-2 en los diagnosticados de mieloma múltiple. Discusión: El seguimiento de pacientes con banda monoclonal benigna es fundamental, al menos durante los cuatro primeros años, ya que con ello podría conseguirse una mayor supervivencia en relación con su transformación en maligna

Objective: To study the clinical course of patients with a serum monoclonal protein at Guadalajara Health Area. Material and methods: Prospective study of 186 patients with a newly diagnosed monoclonal component. They have been collected during the years 1999 and 2000. Results: The cumulative transformation probability at 43 months was 4.99% for those patients whose monoclonal gammopathy was overlooked, and 2% at 23 months for patients with monoclonal gammopathy of undetermined significance. The cumulative probability of survival for patients with multiple myeloma was 66.7% at 21 months. The conditional mortality rate (patients/months) at 4 years due to haematological disease was 4.48x10-4 for overlooked patients, 0 for diagnosed of monoclonal gammopathy of undetermined significance and 1.388x10-2 for multiple myeloma diagnosed. Discussion: A non malignant M component must be followed up due to it could increase patients’ survival rate in relation with transformation in malignant disease

[Follow-up of serum monoclonal gammopathy at Guadalajara Health Area]. / Seguimiento de una cohorte de pacientes con gammapatía monoclonal sérica en el Area Sanitaria de Guadalajara.

OBJECTIVE: To study the clinical course of patients with a serum monoclonal protein at Guadalajara Health Area. MATERIAL AND METHODS: Prospective study of 186 patients with a newly diagnosed monoclonal component. They have been collected during the years 1999 and 2000. RESULTS: The cumulative transformation probability at 43 months was 4.99% for those patients whose monoclonal gammopathy was overlooked, and 2% at 23 months for patients with monoclonal gammopathy of undetermined significance. The cumulative probability of survival for patients with multiple myeloma was 66.7% at 21 months. The conditional mortality rate (patients/months) at 4 years due to haematological disease was 4.48 x 10(-4) for overlooked patients, 0 for diagnosed of monoclonal gammopathy of undetermined significance and 1.388 x 10(-2) for multiple myeloma diagnosed. DISCUSSION: A non malignant M component must be followed up due to it could increase patients survival rate in relation with transformation in malignant disease.

[Monoclonal gammopathy: a frequently overlooked diagnosis]. / Gammapatía monoclonal: un diagnóstico frecuentemente soslayado.

OBJECTIVE: To know the rate of occurrence of monoclonal bands in a clinical laboratory as an estimate of monoclonal gammopathy incidence, and to detect the proportion of these bands in which an explicit clinical diagnosis or follow-up request is not established. Other objectives are to describe its distribution and the characteristics of the patients. PATIENTS AND METHODS: 200 patients were studied in which a monoclonal band had been detected de novo. RESULTS: The incidence was 6.59 x 10(-4) year(-1). In 59.5% a diagnostic assumption was not stated. Most frequent diagnosis in the group of patients with a diagnosis was monoclonal gammopathy with uncertain meaning. Average age of patients was 74.4 years and the difference between percentages by sex was statistically significant. DISCUSSION: The data suggest a lack of clinical effort when the result is the appearance of a monoclonal band. There is no discrepancy in the distribution of the bands and in the characteristics of the patients with regard to what is described in other studies.

Gammapatía monoclonal: un diagnóstico frecuentemente soslayado / Monoclonal gammopathy: a frequently overlooked diagnosis

Objetivo. Conocer la frecuencia de aparición de bandas monoclonales en un laboratorio clínico como estimación de incidencia de gammapatía monoclonal y la proporción de estas bandas en las que no se establece un diagnóstico clínico explícito o propuesta de seguimiento. Otros objetivos son describir su distribución y las características de los pacientes. Pacientes y métodos. Se estudiaron 200 pacientes en los que se había detectado de novo una banda monoclonal. Resultados. La incidencia fue de 6,59 x 10-4 año-1. En el 59,5% no constaba una estimación diagnóstica. En el grupo de diagnosticados la más frecuente fue gammapatía monoclonal de significado incierto. La edad media de los pacientes fue de 74,4 años y la diferencia entre porcentajes por sexo fue estadísticamente significativa. Discusión. Los datos sugieren una falta de esfuerzo clínico cuando el resultado es la aparición de una banda monoclonal. No existe discrepancia en la distribución de las bandas y características de los pacientes respecto a lo descrito en otros estudios (AU)

Objective. To know the rate of occurence of monoclonal bands in a clinical laboratory as an estimate of monoclonal gammopathy incidence, and to detect the proportion of these bands in which an explicit clinical diagnosis or follow-up request is not established. Other objectives are to describe its distribution and the characteristics of the patients. Patients and methods. 200 patients were studied in which a monoclonal band had been detected de novo. Results. The incidence was 6.59 x 10-4 year-1. In 59.5% a diagnostic assumption was not stated. Most frequent diagnosis in the group of patients with a diagnosis was monoclonal gammopathy with uncertain meaning. Average age of patients was 74.4 years and the difference between percentages by sex was statistically significant. Discussion. The data suggest a lack of clinical effort when the result is the appearance of a monoclonal band. There is no discrepancy in the distribution of the bands and in the characteristics of the patients with regard to what is described in other studies (AU)