Immunoparesis and monoclonal gammopathy of undetermined significance are disassociated in advanced age

Benjamin M. Cherry, Rene Costello, Adriana Zingone, Jason Burris, Neha Korde, Elisabet Manasanch, Mary Kwok, Christina Annunziata, Mark J. Roschewski, Eric A. Engels, Ola Landgren*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Immunoparesis and a skewed serum free light chain (FLC) ratio are indicators of immune dysfunction predictive of progression from monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma (MM). Previous studies have reported increased prevalence of MGUS by age, but no study has examined the relationship between immunoparesis and abnormal FLC ratios in the elderly. We screened 453 older adults (median age, 80 years; range, 65-96) to characterize the patterns of immunoparesis and abnormal FLC ratio in relation to MGUS. We defined MGUS in 4.4% of the subjects; the prevalence was 12.5% among individuals of >90 years. In MGUS (vs. non-MGUS) cases, immunoparesis and abnormal FLC ratios were detected in 70.0% (vs. 49.0%; P = 0.07) and 50.0% (vs. 12.9%; P = 0.0001), respectively. Based on small numbers, MGUS patients with abnormal FLC ratio were borderline (P = 0.07) more likely to have immunoparesis. Overall, the prevalence of immunoparesis varied in a nonlinear fashion, with lowest frequencies in the youngest and oldest groups. Our observed disassociation between MGUS prevalence and impaired immunoglobulin production suggests that separate mechanisms are involved in the development of MGUS and immunoparesis in advanced age. These findings emphasize the need for molecularly defined methods to characterize myeloma precursor states and better predict progression to MM.

Original languageEnglish
Pages (from-to)89-92
Number of pages4
JournalAmerican Journal of Hematology
Issue number2
StatePublished - Feb 2013
Externally publishedYes


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