Screening for M-proteinemia consisting of monoclonal gammopathy of undetermined significance and multiple myeloma for 30 years among atomic bomb survivors in Hiroshima

Int J Hematol. 2021 Apr;113(4):576-585. doi: 10.1007/s12185-020-03045-y. Epub 2021 Jan 3.

Abstract

Monoclonal gammopathy (M-proteinemia) is a premalignant plasma cell disorder. The prevalence of M-proteinemia increases with age and is affected by genetic or environmental factors. Atomic bomb (A-bomb) survivors in Hiroshima are in an age range when they are susceptible to M-proteinemia. The prevalence and incidence of M-proteinemia in Hiroshima A-bomb survivors were investigated for 30 years (1989-2018) to examine the influence of radiation exposure. The overall prevalence of M-proteinemia among 38,602 A-bomb survivors was 2.4%. M-proteinemia prevalence at age 70 years and monoclonal gammopathy of undetermined significance (MGUS) incidence were not associated with radiation exposure category. Males had a 2.30-fold higher prevalence and a 2.08-fold higher incidence than females. The risk of incidence for MGUS was 4.32-fold higher in persons aged < 10 years at the time of the A-bombing and 2.56-fold higher in those aged 10-19 years compared with those aged over 30 years. IgG type M-proteinemia was common and the IgM type developed 5-8 years later than other immunoglobulin types. Exposure to radiation was not clearly associated with the prevalence of M-proteinemia or incidence of MGUS in Hiroshima A-bomb survivors. However, males and those aged < 20 years at A-bombing had higher susceptibility to MGUS.

Keywords: A-bomb survivors; Incidence; MGUS; Prevalence; Radiation.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Atomic Bomb Survivors* / statistics & numerical data
  • Biomarkers, Tumor
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin G / blood
  • Immunoglobulin M
  • Incidence
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Male
  • Mass Screening
  • Middle Aged
  • Monoclonal Gammopathy of Undetermined Significance / blood*
  • Monoclonal Gammopathy of Undetermined Significance / diagnosis
  • Monoclonal Gammopathy of Undetermined Significance / epidemiology*
  • Monoclonal Gammopathy of Undetermined Significance / etiology
  • Multiple Myeloma / blood*
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / epidemiology*
  • Multiple Myeloma / etiology
  • Myeloma Proteins*
  • Prevalence
  • Proportional Hazards Models
  • Risk Factors
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Immunoglobulin A
  • Immunoglobulin G
  • Immunoglobulin M
  • Myeloma Proteins
  • multiple myeloma M-proteins