title: Does my patient with a serum monoclonal spike have multiple myeloma?
abstract: A monoclonal spike on serum protein electrophoresis is a frequent finding in the general population and pathognomonic of a plasma cell dyscrasia. In otherwise healthy individuals, it is diagnostic of two asymptomatic, premalignant conditions called monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) which carry a lifelong risk of progression to multiple myeloma (MM) or related malignancy. This article discusses the criteria for diagnosis of MGUS, SMM, and MM; current recommendations for follow-up and risk factors for progression to MM of patients with MGUS and SMM; and diagnostic evaluation of suspected MM transformation.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Giada
authors.initials: G
authors.lastname: Bianchi
authors.forename: Irene M
authors.initials: IM
authors.lastname: Ghobrial
mesh_terms: D018450:Disease Progression; D006801:Humans; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000175:diagnosis* / Q000453:epidemiology; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000453:epidemiology; D010265:Paraproteinemias / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors