ArticleLeukemia2013
Suppression of uninvolved immunoglobulins defined by heavy/light chain pair suppression is a risk factor for progression of MGUS.
Article in Leukemia, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 1 synthesis or guideline pooled it, 109 citations in OpenAlex.
- Rate of MGUS Progression to Haematological Malignancies: A Systematic Review.European journal of haematology · 2026Pooled it
- Multiple myeloma patients in long-term complete response after autologous stem cell transplantation express a particular immune signature with potential prognostic implication.Bone marrow transplantation · 2017Trial
- Comparison of progression risk of monoclonal gammopathy of undetermined significance by method of detection.Blood · 2025Article
- Osteonecrosis of the Jaw Associated with Bisphosphonates Infusion for Treatment of Plasma Cell Myeloma-A Retrospective Observational Study of Northern Portuguese Population.Journal of clinical medicine · 2024Article
- Laboratory and Clinical Settings of Heavy/Light Chain (HLC) Assays in the Management of Monoclonal Gammopathies and Multiple Myeloma.Journal of personalized medicine · 2023Review
- [Clinical characteristics and progression risk factors for patients with monoclonal gammopathy of undetermined significance].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2023Article
- Review
- Immunoparesis defined by heavy/light chain pair suppression in smoldering multiple myeloma shows initial isotype specificity and involves other isotypes in advanced disease.Annals of hematology · 2021Article
- The Current Role of the Heavy/Light Chain Assay in the Diagnosis, Prognosis and Monitoring of Multiple Myeloma: An Evidence-Based Approach.Diagnostics (Basel, Switzerland) · 2021Review
- Monoclonal Gammopathy of Undetermined Significance: Current Concepts and Future Prospects.Current hematologic malignancy reports · 2020Review
- Elevated IgM and abnormal free light chain ratio are increased in relatives from high-risk chronic lymphocytic leukemia pedigrees.Blood cancer journal · 2019Article
- The multiple myelomas - current concepts in cytogenetic classification and therapy.Nature reviews. Clinical oncology · 2018Review
- Flow cytometric aberrancies in plasma cell myeloma and MGUS - correlation with laboratory parameters.Cytometry. Part B, Clinical cytometry · 2018Article
- [The value of serum heavy/light chain immunoassay to assess therapeutic response in patients with multiple myeloma].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2018Article
- Long-Term Follow-up of Monoclonal Gammopathy of Undetermined Significance.The New England journal of medicine · 2018Article
- The clinical utility of serum free light chain and heavy/light chain assays in monitoring disease activity in patients with IgG myeloma after achieving a deep response.Clinical case reports · 2018Article
- Article
- Active multiple myeloma suppresses and typically eliminates coexisting MGUS.British journal of cancer · 2017Article
- Heavy/light chain ratio normalization prior to transplant is of independent prognostic significance in multiple myeloma: a BMT CTN 0102 correlative study.British journal of haematology · 2017Article
- Evolutionary biology of high-risk multiple myeloma.Nature reviews. Cancer · 2017Review
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Authors and funding
14 authors at 5 institutions in 1 country.
Funding
Abstract
We hypothesized that the suppression of uninvolved immunoglobulin in monoclonal gammopathy of undetermined significance (MGUS) as detected by suppression of the isotype-specific heavy and light chain (HLC-pair suppression) increases the risk of progression to malignancy. This approach required quantitation of individual heavy/light chains (for example, IgGλ in IgGκ MGUS patients). Of 1384 MGUS patients from Southeastern Minnesota seen at the Mayo Clinic from 1960 to 1994, baseline serum samples obtained within 30 days of diagnosis were available in 999 persons. We identified HLC-pair suppression in 27% of MGUS patient samples compared with 11% of patients with suppression of uninvolved IgG, IgA or IgM. HLC-pair suppression was a significant risk factor for progression (hazard ratio (HR), 2.3; 95% confidence interval (CI) 1.5-3.7; P<0.001). On multivariate analysis, HLC-pair suppression was an independent risk factor for progression to malignancy in combination with serum M-spike size, heavy chain isotype and free light chain ratio (HR, 1.8; 95% CI, 1.1-3.00; P=0.018). The finding that HLC-pair suppression predicts progression in MGUS and occurs several years before malignant transformation has implications for myeloma biology.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.