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Both cohorts are linked to nationwide information on deaths, cancer registrations and Hospital Episode Statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The UK\u2019s Haematological Malignancy Research Network, which has a catchment population of around 4 million served by 14 hospitals and a central diagnostic laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All patients newly diagnosed during 2009\u20132015 with MGUS (n=2193) or MBL (n=561) and their age and sex-matched comparators (n=27 538).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Mortality and hospital inpatient and outpatient activity in the 5 years before and 3 years after diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Individuals with MGUS experienced excess morbidity in the 5 years before diagnosis and excess mortality and morbidity in the 3 years after diagnosis. Increased rate ratios (RRs) were evident for nearly all clinical specialties, the largest, both before and after diagnosis, being for nephrology (before RR=4.29, 95% CI 3.90 to 4.71; after RR=13.8, 95% CI 12.8 to 15.0) and rheumatology (before RR=3.40, 95% CI 3.18 to 3.63; after RR=5.44, 95% CI 5.08 to 5.83). Strong effects were also evident for endocrinology, neurology, dermatology and respiratory medicine. Conversely, only marginal increases in mortality and morbidity were evident for MBL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MGUS and MBL are generally considered to be relatively benign, since most individuals with monoclonal immunoglobulins never develop a B-cell malignancy or any other monoclonal protein-related organ\/tissue-related disorder. Nonetheless, our findings offer strong support for the view that in some individuals, monoclonal gammopathy has the potential to cause systemic disease resulting in wide-ranging organ\/tissue damage and excess mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-041296","type":"journal-article","created":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T11:40:48Z","timestamp":1613994048000},"page":"e041296","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Health impact of monoclonal gammopathy of undetermined significance (MGUS) and monoclonal B-cell lymphocytosis (MBL): findings from a UK population-based cohort"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1284-9912","authenticated-orcid":false,"given":"Maxine JE","family":"Lamb","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1111-966X","authenticated-orcid":false,"given":"Alexandra","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3936-7569","authenticated-orcid":false,"given":"Daniel","family":"Painter","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7438-9982","authenticated-orcid":false,"given":"Eleanor","family":"Kane","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6150-3467","authenticated-orcid":false,"given":"Timothy","family":"Bagguley","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6715-9153","authenticated-orcid":false,"given":"Robert","family":"Newton","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"},{"name":"Epidemiology and Prevention Programme, Uganda Virus Research Institute, Entebbe, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7521-7402","authenticated-orcid":false,"given":"Debra","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordon","family":"Cook","sequence":"additional","affiliation":[{"name":"Haematology, Leeds Teaching Hospitals NHS Trust, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"de Tute","sequence":"additional","affiliation":[{"name":"Haematological Malignancy Diagnostic Service (HMDS), Leeds Teaching Hospitals NHS Trust, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Rawstron","sequence":"additional","affiliation":[{"name":"Haematological Malignancy Diagnostic Service (HMDS), Leeds Teaching Hospitals NHS Trust, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell","family":"Patmore","sequence":"additional","affiliation":[{"name":"Haematology, Hull University Teaching Hospitals NHS Trust, Hull, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7603-3704","authenticated-orcid":false,"given":"Eve","family":"Roman","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,2,22]]},"reference":[{"key":"2025121601383390000_11.2.e041296.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1709974"},{"key":"2025121601383390000_11.2.e041296.2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-05-505487"},{"key":"2025121601383390000_11.2.e041296.3","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2017.183194"},{"key":"2025121601383390000_11.2.e041296.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa075290"},{"key":"2025121601383390000_11.2.e041296.5","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-12-1348"},{"key":"2025121601383390000_11.2.e041296.6","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2011.450"},{"key":"2025121601383390000_11.2.e041296.7","unstructured":"Swerdlow S , Campo E , Harris N . 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