The clinical implication of monoclonal gammopathies: monoclonal gammopathy of undetermined significance and of renal significance

Krzysztof Batko, Jolanta Malyszko, Artur Jurczyszyn, David H. Vesole, Morie Gertz, Xavier Leleu, Anna Suska, Marcin Krzanowski, Władysław Sułowicz, Jacek S. Malyszko, Katarzyna Krzanowska

Research output: Contribution to journalArticle

Abstract

Monoclonal gammopathy of renal significance (MGRS) has introduced a new perspective to several well-known disease entities impacting nephrology, haematology and pathology. Given the constantly changing disease spectrum of these entities, it is clinically imperative to establish diagnostic and treatment pathways supported by evidence-based medicine. MGRS is a disease of the kidney, secondary to plasma cell clonal proliferation or immune dysfunction, requiring therapeutic intervention to eradicate the offending clone. To fully understand the disease(s), it is prerequisite to determine the significance of the findings. The diagnostic work up should be extensive due to the wide heterogeneity of clinical presentation, ultimately necessitating kidney biopsy. Particular patient profiles such as AL amyloidosis, which may be diagnosed through biopsies of other tissues/organs, may be an exception. Treatment decisions should be formulated by multi-disciplinary consensus: nephrologists, haematologists and pathologists. The ultimate goal in managing MGRS is eradication of the offending plasma cell clone which requires targeted chemotherapy and, in eligible cases, haematopoietic stem cell transplantation. We present a review of diagnostic procedures, treatment options and advances in the last few years in the management of MGRS in an effort to acquaint specialists with this new face of several older diseases.

Original languageEnglish (US)
Pages (from-to)1440-1452
Number of pages13
JournalNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Volume34
Issue number9
DOIs
StatePublished - Sep 1 2019

Fingerprint

Monoclonal Gammopathy of Undetermined Significance
Paraproteinemias
Kidney
Plasma Cells
Clone Cells
Biopsy
Nephrology
Evidence-Based Medicine
Hematopoietic Stem Cell Transplantation
Kidney Diseases
Amyloidosis
Hematology
Therapeutics
Cell Proliferation
Pathology
Drug Therapy

Keywords

  • amyloidosis
  • kidney function
  • monoclonal gammopathy of renal significance
  • monoclonal gammopathy of undetermined significance
  • multiple myeloma

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

The clinical implication of monoclonal gammopathies : monoclonal gammopathy of undetermined significance and of renal significance. / Batko, Krzysztof; Malyszko, Jolanta; Jurczyszyn, Artur; Vesole, David H.; Gertz, Morie; Leleu, Xavier; Suska, Anna; Krzanowski, Marcin; Sułowicz, Władysław; Malyszko, Jacek S.; Krzanowska, Katarzyna.

In: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, Vol. 34, No. 9, 01.09.2019, p. 1440-1452.

Research output: Contribution to journalArticle

Batko, Krzysztof ; Malyszko, Jolanta ; Jurczyszyn, Artur ; Vesole, David H. ; Gertz, Morie ; Leleu, Xavier ; Suska, Anna ; Krzanowski, Marcin ; Sułowicz, Władysław ; Malyszko, Jacek S. ; Krzanowska, Katarzyna. / The clinical implication of monoclonal gammopathies : monoclonal gammopathy of undetermined significance and of renal significance. In: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 2019 ; Vol. 34, No. 9. pp. 1440-1452.
@article{63c006ac6e154bee914380dec69c72bf,
title = "The clinical implication of monoclonal gammopathies: monoclonal gammopathy of undetermined significance and of renal significance",
abstract = "Monoclonal gammopathy of renal significance (MGRS) has introduced a new perspective to several well-known disease entities impacting nephrology, haematology and pathology. Given the constantly changing disease spectrum of these entities, it is clinically imperative to establish diagnostic and treatment pathways supported by evidence-based medicine. MGRS is a disease of the kidney, secondary to plasma cell clonal proliferation or immune dysfunction, requiring therapeutic intervention to eradicate the offending clone. To fully understand the disease(s), it is prerequisite to determine the significance of the findings. The diagnostic work up should be extensive due to the wide heterogeneity of clinical presentation, ultimately necessitating kidney biopsy. Particular patient profiles such as AL amyloidosis, which may be diagnosed through biopsies of other tissues/organs, may be an exception. Treatment decisions should be formulated by multi-disciplinary consensus: nephrologists, haematologists and pathologists. The ultimate goal in managing MGRS is eradication of the offending plasma cell clone which requires targeted chemotherapy and, in eligible cases, haematopoietic stem cell transplantation. We present a review of diagnostic procedures, treatment options and advances in the last few years in the management of MGRS in an effort to acquaint specialists with this new face of several older diseases.",
keywords = "amyloidosis, kidney function, monoclonal gammopathy of renal significance, monoclonal gammopathy of undetermined significance, multiple myeloma",
author = "Krzysztof Batko and Jolanta Malyszko and Artur Jurczyszyn and Vesole, {David H.} and Morie Gertz and Xavier Leleu and Anna Suska and Marcin Krzanowski and Władysław Sułowicz and Malyszko, {Jacek S.} and Katarzyna Krzanowska",
year = "2019",
month = "9",
day = "1",
doi = "10.1093/ndt/gfy259",
language = "English (US)",
volume = "34",
pages = "1440--1452",
journal = "Nephrology Dialysis Transplantation",
issn = "0931-0509",
publisher = "Oxford University Press",
number = "9",

}

TY - JOUR

T1 - The clinical implication of monoclonal gammopathies

T2 - monoclonal gammopathy of undetermined significance and of renal significance

AU - Batko, Krzysztof

AU - Malyszko, Jolanta

AU - Jurczyszyn, Artur

AU - Vesole, David H.

AU - Gertz, Morie

AU - Leleu, Xavier

AU - Suska, Anna

AU - Krzanowski, Marcin

AU - Sułowicz, Władysław

AU - Malyszko, Jacek S.

AU - Krzanowska, Katarzyna

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Monoclonal gammopathy of renal significance (MGRS) has introduced a new perspective to several well-known disease entities impacting nephrology, haematology and pathology. Given the constantly changing disease spectrum of these entities, it is clinically imperative to establish diagnostic and treatment pathways supported by evidence-based medicine. MGRS is a disease of the kidney, secondary to plasma cell clonal proliferation or immune dysfunction, requiring therapeutic intervention to eradicate the offending clone. To fully understand the disease(s), it is prerequisite to determine the significance of the findings. The diagnostic work up should be extensive due to the wide heterogeneity of clinical presentation, ultimately necessitating kidney biopsy. Particular patient profiles such as AL amyloidosis, which may be diagnosed through biopsies of other tissues/organs, may be an exception. Treatment decisions should be formulated by multi-disciplinary consensus: nephrologists, haematologists and pathologists. The ultimate goal in managing MGRS is eradication of the offending plasma cell clone which requires targeted chemotherapy and, in eligible cases, haematopoietic stem cell transplantation. We present a review of diagnostic procedures, treatment options and advances in the last few years in the management of MGRS in an effort to acquaint specialists with this new face of several older diseases.

AB - Monoclonal gammopathy of renal significance (MGRS) has introduced a new perspective to several well-known disease entities impacting nephrology, haematology and pathology. Given the constantly changing disease spectrum of these entities, it is clinically imperative to establish diagnostic and treatment pathways supported by evidence-based medicine. MGRS is a disease of the kidney, secondary to plasma cell clonal proliferation or immune dysfunction, requiring therapeutic intervention to eradicate the offending clone. To fully understand the disease(s), it is prerequisite to determine the significance of the findings. The diagnostic work up should be extensive due to the wide heterogeneity of clinical presentation, ultimately necessitating kidney biopsy. Particular patient profiles such as AL amyloidosis, which may be diagnosed through biopsies of other tissues/organs, may be an exception. Treatment decisions should be formulated by multi-disciplinary consensus: nephrologists, haematologists and pathologists. The ultimate goal in managing MGRS is eradication of the offending plasma cell clone which requires targeted chemotherapy and, in eligible cases, haematopoietic stem cell transplantation. We present a review of diagnostic procedures, treatment options and advances in the last few years in the management of MGRS in an effort to acquaint specialists with this new face of several older diseases.

KW - amyloidosis

KW - kidney function

KW - monoclonal gammopathy of renal significance

KW - monoclonal gammopathy of undetermined significance

KW - multiple myeloma

UR - http://www.scopus.com/inward/record.url?scp=85072041517&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072041517&partnerID=8YFLogxK

U2 - 10.1093/ndt/gfy259

DO - 10.1093/ndt/gfy259

M3 - Article

C2 - 30169860

AN - SCOPUS:85072041517

VL - 34

SP - 1440

EP - 1452

JO - Nephrology Dialysis Transplantation

JF - Nephrology Dialysis Transplantation

SN - 0931-0509

IS - 9

ER -