Prevalence and progression of monoclonal gammopathy of undetermined significance and light-chain MGUS in Germany
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We determined the prevalence and progression rate of monoclonal gammopathy of undetermined significance (MGUS) and light-chain MGUS (LCMGUS) in Germany utilizing the biobank of the population-based Heinz Nixdorf Recall Study. The Heinz Nixdorf Recall Study comprises 4,814 men and women aged 45–75 years. To detect monoclonal proteins, standard serum electrophoresis was combined with parallel screening immunofixation using pentavalent antisera. Additionally, free light chains (FLC) were measured in all samples. Definition of MGUS included M-protein concentration, laboratory results, and disease history. LCMGUS was defined as abnormal FLC ratio, increase in FLC causing the abnormal ratio, and lack of intact immunoglobulin. One hundred sixty-five MGUS cases were identified among 4,702 screened samples (prevalence 3.5%, 95% confidence interval (CI) 3.0–4.1; median age 63 years, range 47–75 years; 103 (62%) male; IgG 59%, IgA 17%, IgM 17%, biclonal 4.8%, kappa 56%, and lambda 44%). Five cases progressed (0.6%/year, 95% CI 0.2–1.4). An abnormal FLC ratio was detected in 220 samples. Thirty-nine of these showed intact immunoglobulin. Thirty-four of the remaining met LCMGUS criteria (prevalence 0.7%, 95% CI 0.5–1.0). None of the LCMGUS cases progressed. We demonstrate a MGUS prevalence of 3.5% and a LCMGUS prevalence of 0.7% in the general population aged 45–75 years in Germany using a sensitive screening approach.
KeywordsMGUS LCMGUS Prevalence Germany Population-based
We thank Anja Führer and Sabrina Kieruzel for expert technical assistance. Furthermore, we thank the Heinz Nixdorf Stiftung (Chairman: Dr. jur. G. Schmidt (deceased), Essen, Germany) for the sponsoring of the Heinz Nixdorf Recall study. We also thank the investigative group and the study personnel of the Heinz Nixdorf Study. We gratefully acknowledge the collaboration with D. Grönemeyer, R. Seibel, L. Volbracht, and M. Bröcker-Preuss. This study was supported by an internal research grant to L.E. from the Faculty of Medicine of the University Hospital of Essen (IFORES). Parts of the study were funded by a research grant from Celgene, Munich, Germany. The Heinz Nixdorf Recall Study was supported by the Heinz Nixdorf Foundation and a research grant from the German Ministry of Education and Science (BMBF).
Heinz Nixdorf Recall Study advisory board: T. Meinertz, Germany (Chair); M. Blettner, Germany; C. Bode, Germany; PJ. de Feyter, the Netherlands; B. Güntert, Austria; F. Gutzwiller, Switzerland; H. Heinen, Germany; O. Hess, Switzerland; B. Klein, Germany; H. Löwel, Germany; M. Reiser, Germany; G. Schmidt, Germany; M. Schwaiger, Germany; C. Steinmüller, Germany; T. Theorell, Sweden; S.N. Willich, Germany.
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