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The incidence and epidemiology of plasma cell neoplasms
1Ontario Cancer Institute/Princess Margaret Hospital, Department of Medicine, Toronto, Canada.
Abstract:
Plasma cell neoplasia includes monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma (MM), and Waldenström's macroglobulinemia (WM). In MGUS, a large, stable clone does not cause symptoms; additional change(s) is/are required to convert this clone into a progressively expanding tumor that becomes symptomatic, as in MM or WM. The prevalence of MGUS (i.e., the number of cases in a defined population at a certain time) is 20 times greater than MM. The incidence (i.e., the number of cases developing in a defined population in a defined period) has not been determined for MGUS. Between 1960 and 1969, the average, annual, age-adjusted (1950 standard) incidence of MM in Malmö, Sweden was 3.4/10(5). The incidence of MM is strongly influenced by the age and race of the population, and the diagnostic services available. MM is a disease of old age; it rarely occurs before the age of 40. The incidence of MM increases rapidly with age, is lowest among the Chinese and Japanese, intermediate among Caucasians in America and Europe, and highest among blacks in the USA. The striking differences in the incidence of MM in different countries appears to be due to racial rather than environmental differences, since the low incidence among the Chinese and Japanese in Asia has migrated with them to the Bay area of California and to Hawaii. The high incidence of MM in USA black males (10.8/10(5)) and females (7.2/10(5)) is more than twice the rate for whites in the same regions.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Monoclonal gammopathy of undetermined significance (MGUS) is more common than symptomatic multiple myeloma (MM). While MGUS is prevalent, its incidence remains undetermined, unlike MM which shows significant age and racial variations.
Area of Science:
- Hematology
- Oncology
- Epidemiology
Background:
- Plasma cell neoplasias encompass monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma (MM), and Waldenström's macroglobulinemia (WM).
- MGUS represents a stable, asymptomatic clone, distinct from symptomatic MM and WM which arise from additional cellular changes.
- The prevalence of MGUS is notably higher, approximately 20 times that of MM.
Purpose of the Study:
- To delineate the epidemiological characteristics of plasma cell neoplasias, focusing on the incidence and prevalence of MGUS and MM.
- To analyze factors influencing the incidence of multiple myeloma, including age, race, and geographical location.
Main Methods:
- Review of epidemiological data concerning plasma cell neoplasias.
- Analysis of incidence rates for multiple myeloma in Malmö, Sweden (1960-1969).
- Comparison of MM incidence across different racial and geographical populations.
Main Results:
- The incidence of MGUS has not been determined, despite its high prevalence compared to MM.
- The annual incidence of MM in Malmö, Sweden, between 1960-1969 was 3.4/10^5.
- MM incidence is strongly correlated with age, being rare before 40 and increasing sharply thereafter.
- Significant racial disparities in MM incidence exist, with higher rates in Black populations in the USA compared to White populations.
- Low incidence rates observed in Chinese and Japanese populations persist across different geographical locations, suggesting a genetic basis.
Conclusions:
- MGUS is a common precursor to more aggressive plasma cell disorders like MM.
- Multiple myeloma incidence is influenced by age and race, with Black populations exhibiting the highest rates.
- Observed racial differences in MM incidence appear to be primarily genetic rather than environmental.