Research Article

Monoclonal Gammopathies in Clinical Hematology in Lomé, Togo: Epidemiology and Diagnostic Profile

Authors: Womey KM Corcellar, Padaro Essohana, Agate P Raoul, Youssaou Nadiatou, N’dadiya EGM Françoise, Egoli K Justin, Edzolevo A Blessing.

DOI: 10.33425/2771-9073.1016

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Abstract

Introduction: monoclonal gammopathies (MGs) encompass a heterogeneous group of disorders ranging from malignant plasma cell neoplasms to indolent conditions such as MGUS. While extensively characterized in high-income countries, data from sub-Saharan Africa remain scarce. We conducted the first comprehensive study of MGs in Togo to describe their epidemiological and diagnostic features.

Methods: we performed a retrospective chart review of patients diagnosed with MGs in the Department of Clinical Hematology at CHU-Campus, Lomé, between June 2011 and April 2024. Inclusion required confirmation of a monoclonal component by serum protein electrophoresis and immunotyping, with complete clinical records available. Data collected included demographics, clinical presentation, laboratory findings, and final diagnosis.

Results: Thirty-nine patients were identified, corresponding to an annual incidence of approximately three new cases. The mean age was 60 years (range, 35–75), with a slight female predominance (sex ratio 0.95). Most cases (84.6%) were diagnosed based on clinical manifestations, whereas only 11.3% were detected incidentally. IgG was the predominant heavy-chain isotype (89.7%), most frequently associated with kappa light chains (56.4%). Multiple myeloma accounted for 82.1% of diagnoses, followed by MGUS (12.8%) and Waldenström’s macroglobulinemia (5.1%).

Conclusion: in this first series from Togo, MGs were most often diagnosed at a symptomatic stage, with multiple myeloma predominating and MGUS rarely identified. The predominance of IgG-kappa is consistent with global trends, but the scarcity of asymptomatic cases highlights underrecognition and limited screening in resource-limited settings. Expanding diagnostic capacity and awareness is essential to improve early detection and patient outcomes in West Africa.

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