Prevalence of Monoclonal Gammopathy of Undetermined Significance in India—A Hospital-based Study

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Abstract

Micro-Abstract

A cross-sectional hospital-based study was undertaken during a 3-month period to ascertain the prevalence of monoclonal gammopathy of undetermined significance (MGUS) in North India. Of the 3429 patients evaluated, MGUS was detected in 49 (1.43%) and multiple myeloma (MM) in 6 (0.17%). To the best of our knowledge, the present study is the first systematic study of the prevalence of MGUS in an Indian population. Our results highlight the relatively low incidence of MGUS in Indians compared with that in white and black populations. The incidental detection of MM in our study points to the need for creating awareness regarding myeloma-related symptoms in appropriate age groups.

Background

We sought to determine the prevalence of monoclonal gammopathy of undetermined significance (MGUS) in a hospital-based cohort in India.

Patients and Methods

From March 2015 to May 2015, 3429 patients (age range, 40-88 years) were enrolled in the present study. Of the 3429 enrolled patients, 2354 (68.6%) were men and 1075 (31.4%) were women. Serum samples were collected from all patients and analyzed using serum protein electrophoresis (SPEP). The positive SPEP samples were subjected to immunofixation. The patients with positive results for both SPEP and immunofixation were registered in the oncology department and investigated further for plasma cell dyscrasias.

Results

Of the 3429 study patients, 49 (1.43%) were found to have MGUS, and multiple myeloma was diagnosed in another 6 (0.17%). The prevalence rate of MGUS in patients aged 40 to 49, 50 to 59, 60 to 69, and 70 to 80 years was 0.83%, 1%, 2.62%, and 1.75%, respectively. Of the 49 MGUS patients, 5 (10.2%) were in the high-intermediate risk category using the Mayo Clinic criteria for risk stratification. At 30 months of follow-up, 1 patient in the high-intermediate category had developed multiple myeloma.

Conclusion

To the best of our knowledge, the present study is the first systematic study on the prevalence of MGUS in an Indian population. The overall prevalence of MGUS was 1.43% in the evaluated Indian cohort, lower than that reported for white and black populations. The incidental detection of 6 subjects with multiple myeloma of 3429 screened subjects in our study was high compared with the reported incidence of multiple myeloma in India of only 1.9 per 100,000 persons. This finding indicates the need to create awareness about myeloma-related symptoms and screening studies in appropriate age groups, at least in the hospital-based setting.

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