How i manage monoclonal gammopathy of undetermined significance

Ronald S. Go, S Vincent Rajkumar

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Monoclonal gammopathy of undetermined significance (MGUS) is, in many ways, a unique hematologic entity. Unlike most hematologic conditions in which the diagnosis is intentional and credited to hematologists, the discovery of MGUS is most often incidental and made by nonhematologists. MGUS is considered an obligate precursor to several lymphoplasmacytic malignancies, including immunoglobulin light-chain amyloidosis, multiple myeloma, and Waldenström macroglobulinemia. Therefore, long-term follow-up is generally recommended. Despite its high prevalence, there is surprisingly limited evidence to inform best clinical practice both at the time of diagnosis and during follow-up. We present 7 vignettes to illustrate common clinical management questions that arise during the course of MGUS. Where evidence is present, we provide a concise summary of the literature and clear recommendations on management. Where evidence is lacking, we describe how we practice and provide a rationale for our approach. We also discuss the potential harms associated with MGUS diagnosis, a topic that is rarely, if ever, broached between patients and providers, or even considered in academic debate.

Original languageEnglish (US)
Pages (from-to)163-173
Number of pages11
JournalBlood
Volume131
Issue number2
DOIs
StatePublished - Jan 11 2018

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Monoclonal Gammopathy of Undetermined Significance
Immunoglobulin Light Chains
Waldenstrom Macroglobulinemia
Amyloidosis
Multiple Myeloma
Practice Guidelines
Neoplasms

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

How i manage monoclonal gammopathy of undetermined significance. / Go, Ronald S.; Rajkumar, S Vincent.

In: Blood, Vol. 131, No. 2, 11.01.2018, p. 163-173.

Research output: Contribution to journalArticle

Go, Ronald S. ; Rajkumar, S Vincent. / How i manage monoclonal gammopathy of undetermined significance. In: Blood. 2018 ; Vol. 131, No. 2. pp. 163-173.
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