From myeloma precursor disease to multiple myeloma: New diagnostic concepts and opportunities for early intervention

Ola Landgren, Robert A. Kyle, S Vincent Rajkumar

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Since monoclonal gammopathy of undetermined significance (MGUS) was first described more than 30 years ago, the definition of the entity has evolved. Today, 3 distinct clinical MGUS subtypes have been defined: non-immunoglobulin M (IgM; IgG or IgA) MGUS, IgM MGUS, and light chain MGUS. Each clinical MGUS subtype is characterized by unique intermediate stages and progression events. Although we now have strong evidence that multiple myeloma is consistently preceded by a precursor state at the molecular level, there is urgent need to better understand mechanisms that regulate transformation from precursor to full-blown multiple myeloma. In the future, if such knowledge was available, it would allow clinicians to define high-risk and low-risk precursor patients for a more tailored clinical management. Also, it would provide insights on the individual patient's disease biology, which, in turn, can be used for targeted and more individualized treatment strategies. On the basis of current clinical guidelines, patients diagnosed with MGUS and smoldering myeloma should not be treated outside of clinical trials. In the near future, it seems reasonable to believe that high-risk precursor patients will likely become candidates for early treatment strategies. In this review, we discuss novel insights from recent studies and propose future directions of relevance for clinical management and research studies.

Original languageEnglish (US)
Pages (from-to)1243-1252
Number of pages10
JournalClinical Cancer Research
Volume17
Issue number6
DOIs
StatePublished - Mar 15 2011

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Monoclonal Gammopathy of Undetermined Significance
Multiple Myeloma
Immunoglobulin M
Immunoglobulin A
Immunoglobulin G
Clinical Trials
Guidelines
Light
Therapeutics
Research

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

From myeloma precursor disease to multiple myeloma : New diagnostic concepts and opportunities for early intervention. / Landgren, Ola; Kyle, Robert A.; Rajkumar, S Vincent.

In: Clinical Cancer Research, Vol. 17, No. 6, 15.03.2011, p. 1243-1252.

Research output: Contribution to journalArticle

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