Elsevier

Mayo Clinic Proceedings

Volume 85, Issue 10, October 2010, Pages 933-942
Mayo Clinic Proceedings

REVIEW
Prevalence of Monoclonal Gammopathy of Undetermined Significance: A Systematic Review

https://doi.org/10.4065/mcp.2010.0337Get rights and content

Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant plasma cell disorder that is associated with a lifelong risk of multiple myeloma. We conducted a systematic review of all studies investigating the prevalence and incidence of MGUS in the online database PubMed. The review was conducted from January 6, 2009, through January 15, 2010. The following MeSH search headings were used: monoclonal gammopathy, benign and prevalence; monoclonal gammopathy, benign and incidence; paraproteinemia and prevalence; and paraproteinemia and incidence. Articles were limited to those written in English and published by January 2009. Fourteen studies that met prespecified criteria were included and systematically assessed to identify the most accurate prevalence estimates of MGUS based on age, sex, and race. On the basis of our systematic review, we estimate that the crude prevalence of MGUS in those older than 50 years is 3.2% in a predominantly white population. Studies in white and Japanese populations demonstrate a clear increase in prevalence with age. The prevalence is also affected by sex: 3.7% and 2.9% in white men and women, respectively; and 2.8% and 1.6% in Japanese men and women, respectively. Additionally, MGUS is significantly more prevalent in black people (5.9%-8.4%) than in white people (3.0%-3.6%). We conclude that MGUS is a common premalignant plasma cell disorder in the general population of those older than 50 years. The prevalence increases with age and is affected by race, sex, family history, immunosuppression, and pesticide exposure. These results are important for counseling, clinical care, and the design of clinical studies in high-risk populations.

Section snippets

Data Sources and Searches

This review was conducted from January 6, 2009, through January 15, 2010. A systematic literature search of PubMed was completed to identify all studies investigating the prevalence and incidence of MGUS. The following MeSH search headings were used: monoclonal gammopathy, benign and prevalence; monoclonal gammopathy, benign and incidence; paraproteinemia and prevalence; and paraproteinemia and incidence. Articles were limited to those written in English and published by January 2009.

Study Selection

Abstracts

RESULTS

Of the 14 studies pertaining to the epidemiology of MGUS (Table 3), 11 (79%) included prevalence measures (Table 4). Of these, 6 (55%) were population-based, 3 (27%) were studiesof hospital populations, and 2 (18%) were retrospective. The remaining 3 studies, 2 of which were retrospective, registry-based studies and one of which was a hospital series study, provided estimates of the incidence of MGUS (Table 5).

DISCUSSION

MGUS falls under an overarching group of plasma cell disorders known as monoclonal gammopathies (or paraproteinemias). This broad category of conditions includes MGUS, multiple myeloma, Waldenström macroglobulinemia, and primary amyloidosis.50 To date, this is the first systematic review of the descriptive epidemiology of MGUS.

The true frequency of MGUS can most accurately be determined through population-based studies that test persons in a geographically defined area during a specified

CONCLUSION

MGUS is one of the most common premalignant disorders in the general population. It is clear that epidemiological investigations will aid in the identification of groups at a high risk of MGUS and thus at a high risk of the subsequent development of multiple myeloma. Such insight will be beneficial for early screening and intervention in high-risk demographics. Future epidemiological investigations must standardize the criteria used for the diagnosis of MGUS, establish universal methods to

Acknowledgments

We extend our gratitude to Victoria A. Dickens, MA, Wael Salem, MPhil, and Fima Macheret, BS, for their thoughtful insight.

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      The annual rate of progression to MM and related lymphoproliferative disorders such as Waldenström's macroglobulinemia, and lymphoma has been reported to be 1% (Kyle et al., 2002), meaning the vast majority of individuals diagnosed with MGUS will not progress to MM. MGUS is more common in males (Wadhera and Rajkumar, 2010), and individuals of black ethnicity (Landgren et al, 2006, 2007). Younger age at diagnosis has been reported among black individuals (median age of diagnosis: 66 vs 70 years old (white individuals) (Landgren et al., 2017).

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    This study was supported in part by grants CA107476 and CA62242 from the National Cancer Institute, Bethesda, MD.

    An earlier version of this article appeared Online First.

    This article is freely available on publication, because the authors have chosen the immediate access option.

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