Prevalence of Monoclonal Gammopathy of Undetermined Significance
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《新英格兰医药杂志》
To the Editor: Kyle et al. (March 30 issue)1 cite a study that my colleagues and I conducted2 that was, contrary to their statement, population based. We found a population prevalence of monoclonal gammopathy of undetermined significance (MGUS) of 3.6 percent among whites. Among the 916 blacks in our study, the prevalence of MGUS was 8.4 percent. The difference in prevalence between whites and blacks was significant (P<0.001). The study in Olmsted County, Minnesota, in which 97 percent of the subjects were white, could not reveal the higher prevalence of MGUS in blacks as compared with whites.
Harvey Jay Cohen, M.D.
Duke University Medical Center
Durham, NC 27710
harvey.cohen@duke.edu
References
Kyle RA, Therneau TM, Rajkumar SV, et al. Prevalence of monoclonal gammopathy of undetermined significance. N Engl J Med 2006;354:1362-1369.
Cohen HJ, Crawford J, Rao MK, Pieper CF, Currie MS. Racial differences in the prevalence of monoclonal gammopathy in a community-based sample of the elderly. Am J Med 1998;104:439-444.
The authors reply: The study conducted by Cohen and colleagues was based on a sample of 4162 subjects from a large five-county geographic population.1 This cohort was assembled by stratified random household sampling of a geographic population, but 2430 subjects (58 percent) were lost for various reasons, leaving less than half the original cohort available for estimating the prevalence of MGUS. For this reason, we did not consider the study to be population based. Our study, by contrast, included 21,463 of 28,038 (77 percent) enumerated residents 50 years of age or older. This difference does not detract from the importance of the study by Cohen et al., which provides important data on the higher prevalence of MGUS in the black population, a finding recently confirmed by Landgren and colleagues.2
Robert A. Kyle, M.D.
S. Vincent Rajkumar, M.D.
L. Joseph Melton III, M.D.
Mayo Clinic
Rochester, MN 55905
kyle.robert@mayo.edu
References
Cohen HJ, Crawford J, Rao MK, Pieper CF, Currie MS. Racial differences in the prevalence of monoclonal gammopathy in a community-based sample of the elderly. Am J Med 1998;104:439-444.
Landgren O, Gridley G, Turesson I, et al. Risk of monoclonal gammopathy of undetermined significance (MGUS) and subsequent multiple myeloma among African American and white veterans in the United States. Blood 2006;107:904-906.
Harvey Jay Cohen, M.D.
Duke University Medical Center
Durham, NC 27710
harvey.cohen@duke.edu
References
Kyle RA, Therneau TM, Rajkumar SV, et al. Prevalence of monoclonal gammopathy of undetermined significance. N Engl J Med 2006;354:1362-1369.
Cohen HJ, Crawford J, Rao MK, Pieper CF, Currie MS. Racial differences in the prevalence of monoclonal gammopathy in a community-based sample of the elderly. Am J Med 1998;104:439-444.
The authors reply: The study conducted by Cohen and colleagues was based on a sample of 4162 subjects from a large five-county geographic population.1 This cohort was assembled by stratified random household sampling of a geographic population, but 2430 subjects (58 percent) were lost for various reasons, leaving less than half the original cohort available for estimating the prevalence of MGUS. For this reason, we did not consider the study to be population based. Our study, by contrast, included 21,463 of 28,038 (77 percent) enumerated residents 50 years of age or older. This difference does not detract from the importance of the study by Cohen et al., which provides important data on the higher prevalence of MGUS in the black population, a finding recently confirmed by Landgren and colleagues.2
Robert A. Kyle, M.D.
S. Vincent Rajkumar, M.D.
L. Joseph Melton III, M.D.
Mayo Clinic
Rochester, MN 55905
kyle.robert@mayo.edu
References
Cohen HJ, Crawford J, Rao MK, Pieper CF, Currie MS. Racial differences in the prevalence of monoclonal gammopathy in a community-based sample of the elderly. Am J Med 1998;104:439-444.
Landgren O, Gridley G, Turesson I, et al. Risk of monoclonal gammopathy of undetermined significance (MGUS) and subsequent multiple myeloma among African American and white veterans in the United States. Blood 2006;107:904-906.