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Biclonal gammopathies: Retrospective study of 47 patients
P García-García1, K Enciso-Alvarez2, F Diaz-Espada2
1Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
Objectives:
Biclonal gammopathies are characterized by the clonal proliferation of plasma cells or their B-lymphoid progenitors and are associated with the production of abnormal immunoglobulins (M proteins or paraproteins). There are no known studies that have analyzed this disease in Spain. We studied the underlying diseases, characteristics of paraproteins and the evolution of a series of patients with biclonal gammopathy.
Material And Methods:
We reviewed clonal gammopathies at the Department of Immunology of Hospital Puerta de Hierro in Madrid, between 1970 and 2011, selecting those patients with biclonal gammopathy in one reading. We collected data on the patient's epidemiology, underlying disease, associated diseases, therapies and paraprotein and immunoglobulin levels.
Results:
Of the 1626 cases of clonal gammapathies, 47 were biclonal gammopathy (2.89%). The median follow-up was 2 years. The main associated condition was biclonal gammopathies of undetermined significance (BGUS). The most common paraprotein combination was IgG-IgG. Upon conducting a second paraprotein reading, 81% of the patients had lost at least 1 monoclonal component. A third of the patients had not undergone treatment.
Conclusions:
Biclonal gammopathy are fundamentally associated with biclonal gammopathies of undetermined significance. No biclonal gammopathies of undetermined significance evolved to a malignant disease. In a high percentage of patients, at least 1 of the 2 clonal components disappeared, sometimes spontaneously.
Insights
Biclonal gammopathy, a condition involving two abnormal immunoglobulin proteins, is often associated with a benign condition. In many cases, one of the abnormal proteins disappears over time, and these conditions do not appear to progress to malignancy.
Area of Science:
- Hematology
- Immunology
Background:
- Biclonal gammopathies involve the proliferation of plasma cells or B-lymphoid progenitors, producing abnormal immunoglobulins.
- No prior studies have specifically analyzed biclonal gammopathies in Spain.
Purpose of the Study:
- To investigate the underlying diseases, paraprotein characteristics, and patient evolution in biclonal gammopathy.
- To analyze the prevalence and characteristics of biclonal gammopathy in Spain.
Main Methods:
- Retrospective review of 1626 clonal gammopathies from 1970-2011.
- Selection of 47 patients with biclonal gammopathy for analysis.
- Data collection on epidemiology, underlying diseases, therapies, and immunoglobulin levels.
Main Results:
- Biclonal gammopathy represented 2.89% of clonal gammopathies, with a median follow-up of 2 years.
- The most common association was biclonal gammopathies of undetermined significance (BGUS), and the most frequent paraprotein combination was IgG-IgG.
- 81% of patients lost at least one monoclonal component upon re-evaluation, and one-third did not receive treatment.
Conclusions:
- Biclonal gammopathies are primarily linked to BGUS, which did not show progression to malignancy in this study.
- A significant percentage of patients experienced the disappearance of at least one clonal component, sometimes spontaneously.
- These findings suggest a generally indolent course for many biclonal gammopathy cases.
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