Immunocytoma in black and white South Africans

The clinical and immunochemical presentations of immunocytomata in black and white South African patients are described. Age distribution in white patients is similar to previously published series. However, black patients with multiple myelomatosis and Waldenstrom's macroglobulinaemia on average presented clinically ten and twenty years respectively earlier than white patients. No significnat differences in the various immunochemical classes of multiple myelomatosis was shown despite greater serum immunoglobulin concentrations (especially IgA) in the black population. Age adjusted incidence rates for multiple myelomatosis in South African blacks were as high as those in the United States and Jamaica. This finding contrasts with low rates previously reported in Africa. Furthermore, age adjusted incidence rates for multiple myelomatosis in South African whites were higher than those in whites reported in the United States. There was a higher incidence in blacks of fractures of the thoracolumbar spine with collapse and consequent paraplegia and urinary tract infection. While there was a greater frequency of solitary myeloma in black patients, cases of benign paraproteinaemia were seen only in white patients.