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Year:
1997
| Volume: 5
| Issue: 2
| Pages: 75-77
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Review Article |
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MONOCLONAL GAMMAPATHIES - ARE THEY ALL MALIGNANCIES OR PREMALIGNANCIES?
Jiri RADL |
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DOI:
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Abstract: |
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This short review of own work questions the wide spread clinical dogma that monoclonal gammapathies (MG) usually reflect a B cell malignancy or at least a pre-malignancy. Research on B-cell proliferative disorders in an animal model - the aging C57BL/KaLwRij mouse - revealed that there are at least four major mechanisms in the development of MG. Many of the findings were confirmed in subsequent clinical studies and lead to a new classification of MG according to their biology and possible pathogenesis. Most of MG can be classified into one of the following 4 categories: 1.B-cell malignancies, 2.B-cell benign neoplasia, 3. MG due to an immunodeficiency with T/B cell imbalance, and 4. Antigen driven MG. The B-cell malignancies, i.e. MG of the first category, represent only ±1% of all MG detected by routine laboratories. However, there are no reliable tests available yet for the differential diagnosis among the 4 categories of MG in the clinical praxis. |
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Key words:
Monoclonal gammapathies-pathogenesis; Monoclonal gammapathies-four categories; B cell proliferative disorders |
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