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Detection and prevalence of monoclonal gammopathy of undetermined significance: a study utilizing mass spectrometry-based monoclonal immunoglobulin rapid accurate mass measurement.
Blood Cancer Journal ( IF 12.9 ) Pub Date : 2019-12-13 , DOI: 10.1038/s41408-019-0263-z
David Murray 1 , Shaji K Kumar 2 , Robert A Kyle 2 , Angela Dispenzieri 2 , Surendra Dasari 3 , Dirk R Larson 4 , Celine Vachon 3 , James R Cerhan 3 , S Vincent Rajkumar 2
Affiliation  

High-sensitivity mass spectrometry assays are available to detect monoclonal immunoglobulins. To better assess the prevalence of monoclonal gammopathy of undetermined significance (MGUS), we identified 300 patients diagnosed with MGUS or related gammopathy who had a prior negative work-up for monoclonal proteins as part of the Olmsted County MGUS screening study. Two mass spectrometry-based detection methods (matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) and monoclonal immunoglobulin rapid accurate mass measurements (miRAMM) along with traditional immunofixation were performed on the Olmsted baseline and MGUS diagnostics serum samples. Among the 226 patients considered negative for MGUS based on protein electrophoresis and serum-free light-chain assay, a monoclonal protein could be detected at baseline in 24 patients (10.6%) by immunofixation, 113 patients (50%) by MADLI-TOF mass spectrometry, and 149 patients (65.9%) by miRAMM mass spectrometry. In addition, using miRAMM, some patients demonstrated an oligoclonal to monoclonal transition giving insight into the origin of MGUS. Using the sensitive miRAMM, MGUS is present in 887 of 17,367 persons from the Olmsted County cohort, translating into a prevalence of 5.1% among persons 50 years of age and older. This represents the most accurate prevalence estimate of MGUS thus far.

中文翻译:

具有未知意义的单克隆丙种球蛋白病的检测和流行:基于质谱的单克隆免疫球蛋白快速准确质量测量的研究。

高灵敏度质谱分析可用于检测单克隆免疫球蛋白。为了更好地评估意义不明的单克隆丙种球蛋白病(MGUS)的患病率,我们确定了300名被诊断为MGUS或相关菌种病的患者事先对单克隆蛋白进行了阴性检查,作为Olmsted County MGUS筛查研究的一部分。在Olmsted基线和MGUS诊断血清样品上进行了两种基于质谱的检测方法(基质辅助激光解吸/电离飞行时间(MALDI-TOF)和单克隆免疫球蛋白快速准确质量测量(miRAMM)以及传统的免疫固定方法。根据蛋白质电泳和无血清轻链分析,在226例MGUS阴性的患者中,有24例在基线时可检测到单克隆蛋白(10。免疫固定法占6%),MADLI-TOF质谱法占113例(50%),miRAMM质谱法占149例(65.9%)。另外,使用miRAMM,一些患者表现出寡克隆至单克隆的转变,从而深入了解了MGUS的起源。使用敏感的miRAMM,来自Olmsted县队列的887名患者中有887名存在于MGUS中,在50岁及以上的人群中,MGUS的患病率为5.1%。这代表了迄今为止MGUS的最准确的患病率估计。奥尔姆斯特德县(Olmsted County)队列中有367人,在50岁以上的人群中占5.1%的患病率。这代表了迄今为止MGUS的最准确的患病率估计。奥尔姆斯特德县(Olmsted County)队列中有367人,在50岁以上的人群中占5.1%的患病率。这代表了迄今为止MGUS的最准确的患病率估计。
更新日期:2019-12-13
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