缺乏有关慢性粒细胞白血病(CML)患者副蛋白血症患病率的数据。
为了评估副蛋白血症的患病率,我们在连续的慢性期CML患者中进行了这项横断面研究.全血细胞计数,化学,免疫球蛋白,无血清轻链,收集血清蛋白电泳和免疫固定。进一步的分析评估了各种患者是否,疾病-,治疗相关变量与副蛋白血症相关。
一百个病人,我们招募了中位年龄63.5岁(IQR48.1~72岁).从CML诊断到入组的中位时间为6.3(IQR2.3-11.3)年。8例患者(8%)检测到单克隆蛋白,诊断为闷烧的多发性骨髓瘤(SMM,n=2)和意义不明的低危单克隆丙种球蛋白病(MGUS,n=6)。6例患者接受酪氨酸激酶抑制剂治疗,2例无治疗缓解。与副蛋白血症相关的唯一协变量是贫血的存在,尽管在单变量分析中具有临界统计学意义(p=0.053),并且在调整年龄时(p=0.056)。
在这项迄今为止最大的研究中,描述了CML患者中副蛋白血症的患病率,我们发现,在50岁以上的普通人群中,MGUS的患病率高于预期的3.2%,且SMM的患病率不可忽略(2%).CML患者的副蛋白血症筛查,尤其是在贫血的情况下,应该考虑。
Data regarding the prevalence of paraproteinemia in patients with chronic myeloid leukemia (CML) are lacking.
To evaluate for the prevalence of paraproteinemia, we undertook this cross-sectional study among consecutive chronic-phase CML patients. Complete blood count, chemistry, immunoglobulins, serum-free light chains, serum-protein electrophoresis and immunofixation were collected. Further analyses evaluated whether various patient-, disease-, and treatment-related variables are associated with paraproteinemia.
One hundred patients, median age 63.5 (IQR 48.1-72) years were recruited. Median time from CML diagnosis to enrollment was 6.3 (IQR 2.3-11.3) years. Monoclonal protein was detected in 8 patients (8%), diagnosed with smoldering multiple myeloma (SMM, n = 2) and low-risk monoclonal gammopathy of undetermined significance (MGUS, n = 6). Six patients were on tyrosine kinase inhibitor treatment, 2 were in treatment-free remission. The only covariate associated with paraproteinemia was the presence of anemia, albeit with borderline statistical significance in univariate analysis (p = 0.053) and when adjusted for age (p = 0.056).
In this largest study so far describing the prevalence of paraproteinemia among CML patients, we found MGUS prevalence to be higher than the 3.2% expected prevalence in the general population above 50 years and a non-negligible prevalence of SMM (2%). Screening for paraproteinemia in CML patients, especially in the presence of anemia, should be considered.