Monoclonal Gammopathies in a Series of 1683 Plasma Donors

Overview

Background.
Monoclonal gammopathies are very heterogenic groups of disorders characterized by the proliferation ofa single clone of plasma cells producing amonoclonal immunoglobulin (paraprotein).Monoclonal gammopathies (Kyle)are classified as malignant monoclonal gammopathies and monoclonal gammopathy of the undetermined significance.The prevalence of paraproteinemias is about 1% in people up to the age of 60 and about 10% in persons older than80 years of age.Methods and Results.We examined blood serumfrom1683 plasma donors (18-60 years) by electrophoretic analysisduring the period 1999-2003.We determined monoclonal immunoglobulins in 10 of them (0.6%). The presence ofmonoclonal gammopathies of undetermined significance was the most frequent (6x), one case was a transientmonoclonal gammopathy, two patients were not examined and one patient (46 years old man) had the diagnosis ofmultiple myeloma. The immunoglobulin class of six paraproteins IgG were observed (4x kappa, 2x lambda),paraprotein IgA was found in two patients (1x kappa, 1x lambda), paraproteinemia IgM-kappa in one patient anddouble paraproteinemia IgG-kappa + IgA-kappa was proved in another one.M-gradient was determined in nine casesby screening electrophoretic analysis on the agarose gel (SEBIA, France). One M-protein (IgA-lambda) was hiddenin beta-globulin region and the diagnosis of multiple myeloma was determined after clinical manifestation thisdisease.Conclusions. Our study shows, that electrophoretic analysis of serum is necessary to do in all types of blood donors(plasma, blood, thrombocytes). Reliable proof of monoclonal immunoglobulins in blood serum or urine is given onlyby immunofixation electrophoresis.

Key words:
blood donors and plasma donors, monoclonal gammopathy, monoclonal immunoglobulin,paraprotein, electrophoresis, immunofixation.