Monoclonal gammopathy of undetermined significance and smouldering multiple myeloma: Emphasis on risk factors for progression

Robert A. Kyle, S Vincent Rajkumar

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Monoclonal gammopathy of undetermined significance (MGUS) is characterized by a serum monoclonal protein <30 g/l, <10% plasma cells in the bone marrow, and absence of end-organ damage (CRAB-hypercalcaemia, renal insufficiency, anaemia, or bone lesions). MGUS is present in 3% of persons >50 years and in 5% >70 years of age. The risk of progression to multiple myeloma (MM) or a related disorder is 1% per year. Patients with risk factors consisting of an abnormal serum free light chain ratio, non-immunoglobulin G (IgG) MGUS, and an elevated serum M protein ≥15 g/l had a risk of progression at 20 years of 58%, compared with 37% with two risk factors present, 21% with one risk factor present, and 5% when none of the risk factors were present. Smouldering (asymptomatic) multiple myeloma is characterized by having a serum IgG or IgA monoclonal protein of 30 g/l or higher and/or 10% or more plasma cells in the bone marrow but no evidence of end-organ damage. The cumulative probability of progression to active MM or amyloidosis was 51% at 5 years, 66% at 10 years and 73% at 15 years; the median time to progression was 4.8 years.

Original languageEnglish (US)
Pages (from-to)730-743
Number of pages14
JournalBritish Journal of Haematology
Volume139
Issue number5
DOIs
StatePublished - Dec 2007

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Monoclonal Gammopathy of Undetermined Significance
Multiple Myeloma
Blood Proteins
Amyloidosis
Plasma Cells
Serum
Immunoglobulin A
Immunoglobulin G
Bone Marrow
Light
Proteins

Keywords

  • Macroglobulinaemia
  • Monoclonal gammopathy of undetermined significance
  • Multiple myeloma
  • Smouldering multiple myeloma

ASJC Scopus subject areas

  • Hematology

Cite this

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abstract = "Monoclonal gammopathy of undetermined significance (MGUS) is characterized by a serum monoclonal protein <30 g/l, <10{\%} plasma cells in the bone marrow, and absence of end-organ damage (CRAB-hypercalcaemia, renal insufficiency, anaemia, or bone lesions). MGUS is present in 3{\%} of persons >50 years and in 5{\%} >70 years of age. The risk of progression to multiple myeloma (MM) or a related disorder is 1{\%} per year. Patients with risk factors consisting of an abnormal serum free light chain ratio, non-immunoglobulin G (IgG) MGUS, and an elevated serum M protein ≥15 g/l had a risk of progression at 20 years of 58{\%}, compared with 37{\%} with two risk factors present, 21{\%} with one risk factor present, and 5{\%} when none of the risk factors were present. Smouldering (asymptomatic) multiple myeloma is characterized by having a serum IgG or IgA monoclonal protein of 30 g/l or higher and/or 10{\%} or more plasma cells in the bone marrow but no evidence of end-organ damage. The cumulative probability of progression to active MM or amyloidosis was 51{\%} at 5 years, 66{\%} at 10 years and 73{\%} at 15 years; the median time to progression was 4.8 years.",
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