Immunoglobulin M Paraproteinaemias
Open Access
- 25 June 2020
- Vol. 12 (6), 1688
- https://doi.org/10.3390/cancers12061688
Abstract
Monoclonal paraproteinaemia is an increasingly common reason for referral to haematology services. Paraproteinaemias may be associated with life-threatening haematologic malignancies but can also be an incidental finding requiring only observation. Immunoglobulin M (IgM) paraproteinaemias comprise 15–20% of monoclonal proteins but pose unique clinical challenges. IgM paraproteins are more commonly associated with lymphoplasmacytic lymphoma than multiple myeloma and can occur in a variety of other mature B-cell neoplasms. The large molecular weight of the IgM multimer leads to a spectrum of clinical manifestations more commonly seen with IgM paraproteins than others. The differential diagnosis of B-cell and plasma cell dyscrasias associated with IgM gammopathies can be challenging. Although the discovery of MYD88 L265P and other mutations has shed light on the molecular biology of IgM paraproteinaemias, clinical and histopathologic findings still play a vital role in the diagnostic process. IgM secreting clones are also associated with a number of “monoclonal gammopathy of clinical significance” entities. These disorders pose a novel challenge from both a diagnostic and therapeutic perspective. In this review we provide a clinical overview of IgM paraproteinaemias while discussing the key advances which may affect how we manage these patients in the future.Keywords
This publication has 129 references indexed in Scilit:
- Imaging in systemic amyloidosisBritish Medical Bulletin, 2013
- Marginal zone B cells: virtues of innate-like antibody-producing lymphocytesNature Reviews Immunology, 2013
- Immunoglobulin heavy/light chain ratios improve paraprotein detection and monitoring, identify residual disease and correlate with survival in multiple myeloma patientsLeukemia, 2012
- EuroFlow antibody panels for standardized n-dimensional flow cytometric immunophenotyping of normal, reactive and malignant leukocytesLeukemia, 2012
- Cold autoimmune haemolytic anaemia secondary to Epstein Barr virus infection presenting with peripheral gangrene; case reportThrombosis Journal, 2012
- The Schnitzler syndromeOrphanet Journal of Rare Diseases, 2010
- Proliferative Glomerulonephritis with Monoclonal IgG DepositsJournal of the American Society of Nephrology, 2009
- Primary Therapy of Waldenström Macroglobulinemia With Bortezomib, Dexamethasone, and Rituximab: WMCTG Clinical Trial 05-180Journal of Clinical Oncology, 2009
- Review of 1027 Patients With Newly Diagnosed Multiple MyelomaMayo Clinic Proceedings, 2003
- Distinct types of diffuse large B-cell lymphoma identified by gene expression profilingNature, 2000