MONOCLONAL GAMMOPATHY IN AUTOIMMUNE DISEASES: ANALYSIS AND FOLLOW-UP OF 160 CASES IN A TERTIARY CENTER IN CHINA
Authors: Huazhen Liu et al.
Monoclonal gammopathy (MG) in patients with autoimmune diseases (AID) is pretty common, but the outcomes and predictors for haematological neoplasm (HN) progression have not been well characterized. 160 Patients diagnosed of AID complicated with MG from January 2010 to June 2017 were systematically reviewed, and followed up.
The most common AID was primary Sjögren’s syndrome (37, 23%), followed by rheumatoid arthritis (28, 18%) and systemic lupus erythematosus (25, 16%).
Thirty-nine (24%) patients developed HN during the follow-up (median: 3.7 years) including multiple myeloma (22), lymphoma (9), macroglobulinemia (4), amyloidosis (3), and plasmacytoma (1). High levels of monoclonal protein, reduction of other types of immunoglobulins and weight loss were independent risk indicators.
The percentage of patients with AID with concomitant monoclonal gammopathy who develop a haematological neoplasm is high. Most of them develop multiple myeloma or lymphomas. Therefore, these patients have to be followed closely together with haematologists. Especially high levels of M protein, weight loss, and the reduction of other immunoglobulins are predisposing factors that warrant vigorous follow-up and monitoring.