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Serum Ig paraprotein was detected in 42 of 218 patients (19.3%), mostly IgM\u2010K (15, 35.7%), followed by IgM\u2010L and IgG\u2010L. Advanced age (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.025), poor Eastern Cooperative Oncology Group performance status (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.014), bone marrow involvement (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.019), B symptoms (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.039), advanced disease stage (III\u2212IV) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001), elevated serum \u03b22\u2010microglobulin level (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001), multiple extranodal sites of involvement (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001), nodal involvement (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001), systemic therapy (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001) and higher MALT\u2010lymphoma International Prognostic Index (MALT\u2010IPI) scores (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) were significantly associated with the presence of serum Ig paraprotein. Multivariate Cox regression analysis showed that Ig paraproteinaemia was an independent prognostic predictor for inferior progression\u2010free survival (PFS) and overall survival. A new prognostic index based on MALT\u2010IPI and Ig paraproteinaemia, as assessed using receiver operating characteristic curves and the area under the curve statistics, showed better discriminative ability than MALT\u2010IPI in predicting PFS. In conclusion, Ig paraproteinaemia was a promising prognostic predictor for MALT lymphoma. Ig paraproteinaemia together with MALT\u2010IPI might contribute to optimising therapeutic management in clinical practice.<\/jats:p>","DOI":"10.1111\/bjh.18000","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T08:08:46Z","timestamp":1640678926000},"page":"1353-1361","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prognostic significance of serum immunoglobulin paraprotein in mucosa\u2010associated lymphoid tissue (MALT) lymphoma"],"prefix":"10.1111","volume":"196","author":[{"given":"Yi\u2010Min","family":"Ren","sequence":"first","affiliation":[{"name":"Department of Hematology the First Affiliated Hospital of Nanjing Medical University Jiangsu Province Hospital  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Yu","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Hematology the First Affiliated Hospital of 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