Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management.
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.
Kyle
R A
RA
Division of Hematology, Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA. kyle.robert@mayo.edu
Durie
B G M
BG
Rajkumar
S V
SV
Landgren
O
O
Blade
J
J
Merlini
G
G
Kröger
N
N
Einsele
H
H
Vesole
D H
DH
Dimopoulos
M
M
San Miguel
J
J
Avet-Loiseau
H
H
Hajek
R
R
Chen
W M
WM
Anderson
K C
KC
Ludwig
H
H
Sonneveld
P
P
Pavlovsky
S
S
Palumbo
A
A
Richardson
P G
PG
Barlogie
B
B
Greipp
P
P
Vescio
R
R
Turesson
I
I
Westin
J
J
Boccadoro
M
M
D018450:Disease Progression; D006801:Humans; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D009101:Multiple Myeloma / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012307:Risk Factors
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