{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T09:53:19Z","timestamp":1781603599160,"version":"3.54.5"},"reference-count":48,"publisher":"Walter de Gruyter GmbH","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic blood disorder that precedes multiple myeloma, and its etiology remains incompletely understood. Risk factors described in the literature include advanced age, male sex, Black race, a family history of plasma cell disorders, and the presence of chronic inflammatory or autoimmune conditions. Furthermore, direct exposure to pesticides has been proposed as a potentially modifiable risk factor. Accordingly, this study aimed to synthesize and evaluate the available evidence on MGUS prevalence and its possible relationship with occupational pesticide exposure among rural workers and pesticide applicators, including prevalence data when reported. A systematic review with meta-analysis was conducted according to Cochrane recommendations. Literature searches were conducted in October 2024 using the Medline (PubMed), Scopus, and Cochrane Library databases to identify relevant primary studies. Four eligible observational studies evaluating MGUS in participants directly exposed to pesticides were included. The studies reported positive associations between specific pesticides, such as aldrin, dieldrin, a carbon tetrachloride\/carbon disulfide mixture, chlorothalonil, petroleum-derived products, and permethrin, and the occurrence of MGUS among rural workers. These findings were analyzed qualitatively due to methodological heterogeneity that precluded pooling of risk estimates. The meta-analysis, restricted to prevalence outcomes, showed that MGUS prevalence increases with age, suggesting age as an important risk factor. The scarcity of published studies and methodological heterogeneity highlight the need for further investigations to better characterize environmental and occupational risks associated with MGUS, which may inform future preventive strategies in higher-risk populations.<\/jats:p>","DOI":"10.1515\/reveh-2025-0022","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T21:17:21Z","timestamp":1775769441000},"page":"253-264","source":"Crossref","is-referenced-by-count":0,"title":["Monoclonal gammopathy of undetermined significance in individuals exposed to pesticides: systematic review and meta-analysis"],"prefix":"10.1515","volume":"41","author":[{"given":"Ana Fl\u00e1via","family":"Redolfi Oliota","sequence":"first","affiliation":[{"name":"Graduate Program in Biosciences and Health at the Western Paran\u00e1 State University , Cascavel , Paran\u00e1 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Millan","family":"Fachi","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1 , Curitiba , Paran\u00e1 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ademar Dantas da","family":"Cunha Junior","sequence":"additional","affiliation":[{"name":"Western Paran\u00e1 State University , Cascavel , Paran\u00e1 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Lucia Frizon","family":"Rizzotto","sequence":"additional","affiliation":[{"name":"Graduate Program in Biosciences and Health, Western Paran\u00e1 State University , Cascavel , Paran\u00e1 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"2026061609052210686_j_reveh-2025-0022_ref_001","doi-asserted-by":"crossref","unstructured":"Rajkumar, SV. 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Br J Haematol 2003;121:749\u201357. https:\/\/doi.org\/10.1046\/j.1365-2141.2003.04355.x.","DOI":"10.1046\/j.1365-2141.2003.04355.x"},{"key":"2026061609052210686_j_reveh-2025-0022_ref_004","doi-asserted-by":"crossref","unstructured":"Kyle, RA, Rajkumar, SV. Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma. Leuk: Off J Leuk Soc Am, Leuk Res Fund, UK 2008;23:3. https:\/\/doi.org\/10.1038\/leu.2008.291.","DOI":"10.1038\/leu.2008.291"},{"key":"2026061609052210686_j_reveh-2025-0022_ref_005","doi-asserted-by":"crossref","unstructured":"Wadhera, RK, Rajkumar, SV. Prevalence of monoclonal gammopathy of undetermined significance: a systematic review. Mayo Clin Proc 2010;85:933\u201342. https:\/\/doi.org\/10.4065\/mcp.2010.0337.","DOI":"10.4065\/mcp.2010.0337"},{"key":"2026061609052210686_j_reveh-2025-0022_ref_006","doi-asserted-by":"crossref","unstructured":"Bhutani, M, Blue, BJ, Cole, C, Badros, AZ, Usmani, SZ, Nooka, AK, et al.. Addressing the disparities: the approach to the African American patient with multiple myeloma. Blood Cancer J 2023;13:189. https:\/\/doi.org\/10.1038\/s41408-023-00961-0.","DOI":"10.1038\/s41408-023-00961-0"},{"key":"2026061609052210686_j_reveh-2025-0022_ref_007","doi-asserted-by":"crossref","unstructured":"Kyle, RA, Therneau, TM, Rajkumar, SV, Larson, DR, Plevak, MF, Offord, JR, et al.. Prevalence of monoclonal gammopathy of undetermined significance. N\u00a0Engl J Med 2006;354:1362\u20139. https:\/\/doi.org\/10.1056\/NEJMoa054494.","DOI":"10.1056\/NEJMoa054494"},{"key":"2026061609052210686_j_reveh-2025-0022_ref_008","doi-asserted-by":"crossref","unstructured":"Landgren, O, Gridley, G, Turesson, I, Caporaso, NE, Goldin, LR, Baris, D, et al.. Risk of monoclonal gammopathy of undetermined significance (MGUS) and subsequent multiple myeloma among African American and white veterans in the United\u00a0States. 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Blood 2009;114:791\u20135. https:\/\/doi.org\/10.1182\/blood-2008-12-191676.","DOI":"10.1182\/blood-2008-12-191676"},{"key":"2026061609052210686_j_reveh-2025-0022_ref_011","doi-asserted-by":"crossref","unstructured":"Brown, LM, Gridley, G, Check, D, Landgren, O. Risk of multiple myeloma and monoclonal gammopathy of undetermined significance among white and black male United\u00a0States veterans with prior autoimmune, infectious, inflammatory, and allergic disorders. Blood 2008;111:3388\u201394. https:\/\/doi.org\/10.1182\/blood-2007-10-121285.","DOI":"10.1182\/blood-2007-10-121285"},{"key":"2026061609052210686_j_reveh-2025-0022_ref_012","doi-asserted-by":"crossref","unstructured":"Abeykoon, JP, Tawfiq, RK, Kumar, S, Ansell, SM. Monoclonal gammopathy of undetermined significance: evaluation, risk assessment, management, and beyond. 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Blood Adv 2023;7:5510\u201323. https:\/\/doi.org\/10.1182\/bloodadvances.2023010822.","DOI":"10.1182\/bloodadvances.2023010822"},{"key":"2026061609052210686_j_reveh-2025-0022_ref_015","doi-asserted-by":"crossref","unstructured":"Pasqualetti, P, Festuccia, V, Acitelli, P, Collacciani, A, Giusti, A, Casale, R. Tobacco smoking and risk of haematological malignancies in adults: a case\u2013control study. Br J Haematol 1997;97:659\u201362. https:\/\/doi.org\/10.1046\/j.1365-2141.1997.942910.x.","DOI":"10.1046\/j.1365-2141.1997.942910.x"},{"key":"2026061609052210686_j_reveh-2025-0022_ref_016","doi-asserted-by":"crossref","unstructured":"Boursi, B, Weiss, BM, Haynes, K, Mamtani, R, Yang, Y-X. Reappraisal of risk factors for monoclonal gammopathy of undetermined significance; 2016. https:\/\/doi.org\/10.1002\/ajh.24355.","DOI":"10.1002\/ajh.24355"},{"key":"2026061609052210686_j_reveh-2025-0022_ref_017","doi-asserted-by":"crossref","unstructured":"Kyle, RA, Therneau, TM, Rajkumar, SV, Offord, JR, Larson, DR, Plevak, MF, et al.. A long-term study of prognosis in monoclonal gammopathy of undetermined significance. N\u00a0Engl J Med 2002;346:564\u20139. https:\/\/doi.org\/10.1056\/NEJMoa01133202.","DOI":"10.1056\/NEJMoa01133202"},{"key":"2026061609052210686_j_reveh-2025-0022_ref_018","doi-asserted-by":"crossref","unstructured":"Rajkumar, SV, Kyle, RA, Therneau, TM, Melton, LJ, Bradwell, AR, Clark, RJ, et al.. Serum free light chain ratio is an independent risk factor for progression in monoclonal gammopathy of undetermined significance. 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