Study On Monoclonal Immunoglobulinemia With Secondary Significance

Background and aims:In recent years, the application of high dose chemotherapy with Autologous Stem Cell Transplantation(Auto-SCT) and new drugs, significantly improved the prognosis of multiple myeloma (multiple myeloma, MM). During the treatment,some of the patients developed new or additional serum Ig or Ig light chain disorders, which we termed secondary MGUS. The mechanism is still uncertain, It appears not only in the treatment of multiple myeloma, but also appears in other malignant tumor after stem cell transplantation. The researches on the sMGUS developed increasingly, many studies have found that sMGUS is not a signal of malignant disease. In1998, the sMGUS was not considered relapse during the treatment of multiple myeloma by the guideline of IMWG. We retrospectively analyzed515multiple myeloma patients in our hospital, which found35cases of sMGUS, here we report the characteristics of sMGUS, analyze the survival and prognosis in these patients.Methods:Retrospective analysis the data of515patients with multiple myeloma admitted in our hospital, which received hematopoietic stem cell transplantation for treatment of73cases of patients, chemotherapy in442patients, analysis the results of immunofixation electrophoresis(IFE) and clinical characteristics respectively, and compared the curative effect and survival analysis of sMGUS group and non-sMGUS group.Results:There were35cases of sMGUS found in all patients,and the occurrence rate is6.8%;the sMGUS probability after hematopoietic stem cell transplantation treatment and chemotherapy treatment were19.2%and4.8%respectively, there was statistical significance between the two groups (x2=20.587, P<0.05). The CR rate of sMGUS group and non-sMGUS group were45.7%and14.3%, there was statistical significant difference between the two groups(x2=22.961, P<0.001); The median survival time of sMGUS group was42months (5～112months), and the non-sMGUS group’s was14months (1～120months), there was statistical significant difference between the2groups (P<0.001). In the patients who receive the treatment of hematopoietic stem cell transplant, the sMGUS group’s median survival of30.8months (5～111), while non-sMGUS group’s was39.3months (2～120months), there was statistical difference between the two groups (P<0.05).Conclusion:(1) The incidence of sMGUS in multiple myeloma by chemotherapy combined with Auto-SCT is more than the patient who achieve only chemotherapy.(2) The frequency of sMGUS after Auto-SCT treatment is higher than chemotherapy. (3) The sMGUS group has the better disease progress and better prognosis, but for Auto-SCT treatment patients, sMGUS may be not a Good prognostic factor.