Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management

R. A. Kyle, B. G.M. Durie, S. V. Rajkumar, O. Landgren, J. Blade, G. Merlini, N. Kröger, H. Einsele, D. H. Vesole, M. Dimopoulos, J. San Miguel, H. Avet-Loiseau, R. Hajek, W. M. Chen, K. C. Anderson, H. Ludwig, P. Sonneveld, S. Pavlovsky, A. Palumbo, P. G. RichardsonB. Barlogie, P. Greipp, R. Vescio, I. Turesson, J. Westin, M. Boccadoro

Research output: Contribution to journalReview articlepeer-review

541 Scopus citations

Abstract

Monoclonal gammopathy of undetermined significance (MGUS) was identified in 3.2% of 21 463 residents of Olmsted County, Minnesota, 50 years of age or older. The risk of progression to multiple myeloma, Waldenstrom's macroglobulinemia, AL amyloidosis or a lymphoproliferative disorder is approximately 1% per year. Low-risk MGUS is characterized by having an M protein < 15 g/l, IgG type and a normal free light chain (FLC) ratio. Patients should be followed with serum protein electrophoresis at six months and, if stable, can be followed every 2-3 years or when symptoms suggestive of a plasma cell malignancy arise. Patients with intermediate and high-risk MGUS should be followed in 6 months and then annually for life. The risk of smoldering (asymptomatic) multiple myeloma (SMM) progressing to multiple myeloma or a related disorder is 10% per year for the first 5 years, 3% per year for the next 5 years and 1-2% per year for the next 10 years. Testing should be done 2-3 months after the initial recognition of SMM. If the results are stable, the patient should be followed every 4-6 months for 1 year and, if stable, every 6-12 months.

Original languageEnglish (US)
Pages (from-to)1121-1127
Number of pages7
JournalLeukemia
Volume24
Issue number6
DOIs
StatePublished - Jun 2010

Keywords

  • International Myeloma Working Group
  • MGUS
  • monoclonal gammopathy of undetermined significance
  • smoldering multiple myeloma

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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