Monoclonal Gammopathies in Africa

Abstract

People of African descent have a reported higher incidence of multiple myeloma (MM) and increased prevalence of its precursor conditions, monoclonal gammopathy of undetermined significance (MGUS) and smoldering MM (SMM). Despite this, research focusing on people of African descent remains sparse. Even in the absence of robust studies across African populations, major disparities are consistently reported. West Africans and South African Black men have a higher prevalence of MGUS than individuals of European descent. MM has been shown to occur in African individuals at a younger age of diagnosis compared to European individuals, with a relatively higher proportion of females (M/F ∼1 vs. 1.4 in Europeans), delayed diagnosis (symptoms to diagnosis 10-12 months), and a higher prevalence of bone disease at presentation. This review summarizes the existing literature on monoclonal gammopathies for African people and highlights critical gaps in our understanding of the disease within the diverse African population. Importantly, differences in disease biology, with respect to cytogenetic and immunologic differences, which contribute to disparate disease outcomes are discussed. Concerted efforts to bridge knowledge gaps through collaborative research initiatives, both within and beyond the African continent, are urgently needed.

Keywords: Cytogenetic abnormalities; HIV; Health disparities; MGUS; Myeloma.