Monoclonal gammopathy of undetermined significance: a consensus statement

Abstract

SummaryOn February 25, 2009, a panel of international experts on plasma cell dyscrasia and skeletal disease met to discuss monoclonal gammopathy of undetermined significance (MGUS). This non-malignant B-cell disorder is the most common plasma cell dyscrasia and is associated with an increased risk of developing serious B-cell disorders. Individuals with MGUS also have an increased risk of osteoporosis and osteopenia associated with an increased likelihood of developing fractures especially in the vertebral column, peripheral neuropathy and thromboembolic events. The goal of the meeting was to develop a consensus statement regarding the appropriate tests to screen, evaluate and follow-up patients with MGUS. The panel also addressed the identification and treatment of MGUS-related skeletal problems, thromboembolic events and neurological complications. The following consensus statement outlines the conclusions and marks the first time that a consensus statement for the screening and treatment of MGUS has been clearly stated.

Schnitzler syndrome: an under-diagnosed clinical entity

“…12,13 Likewise, MGUS is also common in the general population and its prevalence increases with age. 14,15 Interestingly, Bida et al observed that the prevalence of urticaria in patients with MGUS is lower than in the general population (3.3% vs. 5.9% for a risk ratio of 0.6; P=0.02). 11 The monoclonal protein in MGUS is an IgM isotype in 15-20% of cases.…”

Thrombosis in Multiple Myeloma

“…The same thromboprophylactic strategy should be applied in MGUS patients as in other patients, in accordance with clinical guidelines. 31,34 All MM patients who do not have excess risk of bleeding and are treated with thalidomide or lenalidomide in combination with dexamethasone or chemotherapy, should receive thromboprophylaxis. In light of the recent randomized clinical trials, aspirin, LMWH, and fixed, low-dose warfarin seem to be effective in thalidomide-treated patients.…”

Monoclonal Gammopathy of Undetermined Significance and Multiple Myeloma in Older Adults

“…18 MGUS is highly prevalent, progresses to MM in only a small percentage of patients, 19 and there is no known strategy to prevent that progression. 18 Geriatricians should consider a diagnostic work-up for plasma cell disorders only when a reason to suspect one exists. The diagnostic criteria for MM, SMM, and MGUS were recently updated (Box 1).…”