TRICLONAL GAMMOPATHY AND MALIGNANT IMMUNO -PROLIFERATIVE DISEASE

Three distinct monoclonal gammopathies were identified in the serum of a 79 year-old man. In 1972 he presented with Waldenstrom's macroglobu linemia IgM Kappa. Twenty years later multiple myeloma was diagnosed. Serum protein electrophoresis performed at this time showed three mono clonal bands. Immunofixation identified these bands as monoclonal IgM kappa, Ige kappa and IgA kappa. Twenty-six cases of triclonal gammopat hies were previously reported. Sixteen cases were associated with mali gnant immuno-proliferative diseases (non-hodgkin lymphoma, Waldenstrom 's macroglobulinemia, multiple myeloma); five cases with non-hematolog ic diseases; three cases were of undetermined significance. The origin of three distinct monoclonal proteins may derive from three unrelated clones or alternatively from a single clone in which an isotype switc h has occurred.