Management of paraproteinaemia.
A paraprotein is a monoclonal immunoglobulin or light chain present in the blood or urine; it is produced by a clonal population of mature B cells, most commonly plasma cells. In individuals aged >50 years the incidence of a paraprotein is 3.2%. Plasma cell disorders can be considered as a spectrum of conditions ranging from monoclonal gammopathy of undetermined significance (MGUS), through asymptomatic, to symptomatic myeloma. MGUS is defined by a low level of paraprotein <30 g/l, bone marrow plasma cells <10% and the absence of myeloma related organ or tissue damage (predominantly renal, skeletal or bone marrow impairment.) MGUS requires no therapy and the overall risk of progression to myeloma is 1% per year. Myeloma remains incurable with a median survival of 3-4 years; autologous stem cell transplant can prolong survival, if appropriate. Thalidomide in combination with dexamethasone has an emerging role in the treatment of myeloma.
Cook
Lucy
L
Department of Haematology, Imperial College, London, UK.
Macdonald
Donald H C
DH
D000740:Anemia / Q000209:etiology; D003937:Diagnosis, Differential; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D006934:Hypercalcemia / Q000628:therapy; D007239:Infections / Q000209:etiology; D007674:Kidney Diseases / Q000209:etiology; D009101:Multiple Myeloma / Q000175:diagnosis; D010146:Pain / Q000517:prevention & control; D010265:Paraproteinemias / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011379:Prognosis; D012017:Referral and Consultation
D004164:Diphosphonates