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Abstract：
Monoclonal gammopathy of undetermined significance (MGUS) is an indolent, premalignant plasma cell disorder with the potential of transforming into symptomatic multiple myeloma (MM). There are multiple risk factors that contribute to transformation. Agent Orange (AO) has been linked with multiple malignant and nonmalignant conditions.
We conducted a retrospective chart review of patients with monoclonal gammopathy who were seen at John D. Dingell Veterans Affairs Medical Center (Detroit, Michigan) between 2005 and 2015 with MGUS, smoldering multiple myeloma, and MM. We explored baseline patient characteristics and explored AO exposure. Dates of diagnosis, dates of progression, and expiration dates were recorded to time to progression and overall survival (OS).
We identified 211 patients with monoclonal gammopathy; 96% were male and 122 were African American. Eleven patients had reported AO exposure. Cumulative risk of progression in the overall population was 1.4% at 1 year. Risk of transformation in the population exposed to AO was significantly higher with a hazard ratio (HR) of 11.19 (95% confidence interval [CI], 2.10-59.47; P = .005). OS was numerically shorter in AO-exposed patients with a median OS of 7 years compared with 11.1 years in those not exposed. However, AO exposure was not associated with OS in multivariable analysis (HR, 0.50; 95% CI, 0.07-3.83; P = .508).
Monoclonal gammopathy is a premalignant condition with the risk of progressing to MM. Exposure to AO has been implicated in multiple conditions including MM. Our study demonstrates an increased risk of progression in exposed patients.
We conducted a retrospective chart review of patients with monoclonal gammopathy who were seen at John D. Dingell Veterans Affairs Medical Center (Detroit, Michigan) between 2005 and 2015 with MGUS, smoldering multiple myeloma, and MM. We explored baseline patient characteristics and explored AO exposure. Dates of diagnosis, dates of progression, and expiration dates were recorded to time to progression and overall survival (OS).
We identified 211 patients with monoclonal gammopathy; 96% were male and 122 were African American. Eleven patients had reported AO exposure. Cumulative risk of progression in the overall population was 1.4% at 1 year. Risk of transformation in the population exposed to AO was significantly higher with a hazard ratio (HR) of 11.19 (95% confidence interval [CI], 2.10-59.47; P = .005). OS was numerically shorter in AO-exposed patients with a median OS of 7 years compared with 11.1 years in those not exposed. However, AO exposure was not associated with OS in multivariable analysis (HR, 0.50; 95% CI, 0.07-3.83; P = .508).
Monoclonal gammopathy is a premalignant condition with the risk of progressing to MM. Exposure to AO has been implicated in multiple conditions including MM. Our study demonstrates an increased risk of progression in exposed patients.
摘要：
意义不明的单克隆丙种球蛋白病（MGUS）是一种惰性，有可能转化为症状性多发性骨髓瘤（MM）的癌前浆细胞疾病。有多种风险因素促成转型。橙剂（AO）与多种恶性和非恶性疾病有关。
我们对在约翰·丁格尔退伍军人事务医疗中心（底特律，密歇根州)在2005年至2015年期间使用MGUS，阴燃的多发性骨髓瘤，嗯。我们探索了基线患者特征并探索了AO暴露。诊断日期,进展日期，和过期日期记录至进展时间和总生存期(OS).
我们确定了211例单克隆丙种球蛋白病患者；96%为男性，122例为非洲裔美国人。11名患者报告了AO暴露。1年时，总体人群的累积进展风险为1.4％。暴露于AO的人群的转化风险显著高于风险比(HR)11.19(95%置信区间[CI],2.10-59.47；P=.005）。与未暴露患者的11.1年相比，AO暴露患者的OS在数字上较短，中位OS为7年。然而,在多变量分析中，AO暴露与OS无关(HR，0.50；95%CI，0.07-3.83；P=.508）。
单克隆丙种球蛋白病是一种癌前疾病，有进展为MM的风险。暴露于AO涉及多种条件，包括MM。我们的研究表明暴露患者的进展风险增加。
我们对在约翰·丁格尔退伍军人事务医疗中心（底特律，密歇根州)在2005年至2015年期间使用MGUS，阴燃的多发性骨髓瘤，嗯。我们探索了基线患者特征并探索了AO暴露。诊断日期,进展日期，和过期日期记录至进展时间和总生存期(OS).
我们确定了211例单克隆丙种球蛋白病患者；96%为男性，122例为非洲裔美国人。11名患者报告了AO暴露。1年时，总体人群的累积进展风险为1.4％。暴露于AO的人群的转化风险显著高于风险比(HR)11.19(95%置信区间[CI],2.10-59.47；P=.005）。与未暴露患者的11.1年相比，AO暴露患者的OS在数字上较短，中位OS为7年。然而,在多变量分析中，AO暴露与OS无关(HR，0.50；95%CI，0.07-3.83；P=.508）。
单克隆丙种球蛋白病是一种癌前疾病，有进展为MM的风险。暴露于AO涉及多种条件，包括MM。我们的研究表明暴露患者的进展风险增加。
