{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,21]],"date-time":"2024-07-21T02:49:58Z","timestamp":1721530198508},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T00:00:00Z","timestamp":1519862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Monoclonal gammopathy of undetermined significance (MGUS) precedes multiple myeloma in virtually every case. However, only a small percentage will progress and at very different rates. In addition, recent data have suggested that MGUS is associated with other comorbidities including infections, suggesting impaired immune function in some MGUS patients. Therefore, we aimed at assessing the value of isotype-matched immunosuppression (IMI; e.g., suppression of an IgA\u03ba in an IgA\u03bb patient), a type of immunosuppression more specific than classical immunoparesis (IP; e.g., IgG and\/or IgM suppression in an IgA patient), as a prognostic marker for MGUS progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Hevylite assay was used to assess IMI and immunoglobulin ratios in 307 serum samples from a cohort of 248 MGUS patients. Follow-up clinical records were available for 154 individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A greater incidence of IMI (51%) over classical IP (37%) was observed, although both show a progressive increase with higher risk groups. Survival analysis of 154 patients showed that severe IMI (&amp;gt;50% suppression) differentiates 2 groups with significantly different time to progression (P = 0.024) while severe IP does not (P = 0.48). Also, a combination of severe IMI and involved monoclonal immunoglobulin &amp;gt;1.5g\/dL by Hevylite (both variables found to be independent prognostic markers in multivariate analysis) identified a group of patients with a median time to progression 6-fold shorter than the remaining group (P &amp;lt; 0.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings indicate a possible role for IMI in the malignant transformation of MGUS patients and a potential utility as a new risk factor.<\/jats:p><\/jats:sec>","DOI":"10.1373\/jalm.2017.024307","type":"journal-article","created":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T23:05:15Z","timestamp":1532387115000},"page":"700-710","source":"Crossref","is-referenced-by-count":3,"title":["Severe Isotype-Matched Immunosuppression (IMI) as a Potential Risk Factor for Progression of MGUS Patients"],"prefix":"10.1093","volume":"2","author":[{"given":"Juana J","family":"Jim\u00e9nez","sequence":"first","affiliation":[{"name":"Department of Clinical Chemistry, University Hospital Severo Ochoa, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiago M","family":"Pais","sequence":"additional","affiliation":[{"name":"Scientific Department, The Binding Site Iberia, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuno","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Scientific Department, The Binding Site Iberia, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Luisa","family":"Campos","sequence":"additional","affiliation":[{"name":"Scientific Department, The Binding Site Iberia, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Antonia Pe\u00f1alver","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Department of Haematology, University Hospital Severo Ochoa, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen H","family":"de Larramendi","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, University Hospital Severo Ochoa, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,3,1]]},"reference":[{"key":"2022020109125072100_B1","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/j.1365-2141.2006.06235.x","article-title":"Monoclonal gammopathy of undetermined significance","volume":"134","author":"Kyle","year":"2006","journal-title":"Br J Haematol"},{"key":"2022020109125072100_B2","first-page":"785","article-title":"Increased incidence of monoclonal gammopathy of undetermined significance in blacks and its age-related differences with whites on the basis of a study of 397 men and one woman in a hospital setting","volume":"116","author":"Singh","year":"1990","journal-title":"J Lab Clin 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