The presence of a serum paraprotein (PP) is usually associated with plasma-cell dyscrasias, Waldenstrom Macroglobulinemia/lymphoplasmacytic lymphoma, and cryoglobulinemia. However, PP is also often reported in other high- and low-grade B-cell malignancies. As these reports are sparse and heterogeneous, an overall view on this topic is lacking, Therefore, we carried out a complete literature review to detail the characteristics, and highlight differences and similarities among lymphoma entities associated with PP. In these settings, IgM and IgG are the prevalent PP subtypes, and their serum concentration is often low or even undetectable without immunofixation. The relevance of paraproteinemia and its prevalence, as well as the impact of IgG vs. IgM PP, seems to differ within B-NHL subtypes and CLL. Nonetheless, paraproteinemia is almost always associated with advanced disease, as well as with immunophenotypic, genetic, and clinical features, impacting prognosis. In fact, PP is reported as an independent prognostic marker of poor outcome. All the above call for implementing clinical practice, with the assessment of paraproteinemia, in patients’ work-up. Indeed, more studies are needed to shed light on the biological mechanism causing more aggressive disease. Furthermore, the significance of paraproteinemia, in the era of targeted therapies, should be assessed in prospective trials.
血清副蛋白（PP）的存在通常与浆细胞疾病、华氏巨球蛋白血症/淋巴浆细胞淋巴瘤以及冷球蛋白血症相关。然而，在其他高级别和低级别B细胞恶性肿瘤中也常报道PP的存在。由于这些报道零散且异质性高，目前缺乏对该主题的整体认识。因此，我们进行了全面的文献综述，以详细描述与PP相关的淋巴瘤实体的特征，并突出它们之间的差异和相似性。在这些情况下，IgM和IgG是主要的PP亚型，其血清浓度通常较低，甚至在没有免疫固定检测的情况下无法检测到。副蛋白血症的相关性及其患病率，以及IgG与IgM PP的影响，似乎在B细胞非霍奇金淋巴瘤亚型和慢性淋巴细胞白血病中有所不同。尽管如此，副蛋白血症几乎总是与疾病晚期以及免疫表型、遗传和临床特征相关，并影响预后。事实上，PP被报道为不良预后的独立预后标志物。综上所述，在患者的诊疗过程中，应通过评估副蛋白血症来指导临床实践。确实，需要更多的研究来阐明导致疾病更具侵袭性的生物学机制。此外，在靶向治疗时代，副蛋白血症的意义应在前瞻性试验中进行评估。
肿瘤(癌症)患者之家