Monoclonal Gammopathies of Undetermined Significance and Smoldering Multiple Myeloma

2004 ◽  
pp. 1-33
Author(s):  
Robert A. Kyle ◽  
S. Vincent Rajkumar
Keyword(s):  
Multiple Myeloma ◽  
Monoclonal Gammopathies ◽  
Smoldering Multiple Myeloma ◽  
Undetermined Significance

scholarly journals Characteristics of MGUS and Multiple Myeloma According to the Target of Monoclonal Immunoglobulins, Glucosylsphingosine, or Epstein-Barr Virus EBNA-1

Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1254 ◽  
Author(s):  
Adrien Bosseboeuf ◽  
Nicolas Mennesson ◽  
Sophie Allain-Maillet ◽  
Anne Tallet ◽  
Eric Piver ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Epstein Barr Virus ◽  
Mild Form ◽  
Chronic Stimulation ◽  
Monoclonal Gammopathies ◽  
Barr Virus ◽  
Smoldering Multiple Myeloma ◽  
Monoclonal Immunoglobulins ◽  
Epstein Barr ◽  
Undetermined Significance

Chronic stimulation by infectious or self-antigens initiates subsets of monoclonal gammopathies of undetermined significance (MGUS), smoldering multiple myeloma (SMM), or multiple myeloma (MM). Recently, glucosylsphingosine (GlcSph) was reported to be the target of one third of monoclonal immunoglobulins (Igs). In this study of 233 patients (137 MGUS, 6 SMM, 90 MM), we analyzed the GlcSph-reactivity of monoclonal Igs and non-clonal Igs. The presence of GlcSph-reactive Igs in serum was unexpectedly frequent, detected for 103/233 (44.2%) patients. However, GlcSph was targeted by the patient’s monoclonal Ig for only 37 patients (15.9%); for other patients (44 MGUS, 22 MM), the GlcSph-reactive Igs were non-clonal. Then, the characteristics of patients were examined: compared to MM with an Epstein-Barr virus EBNA-1-reactive monoclonal Ig, MM patients with a GlcSph-reactive monoclonal Ig had a mild presentation. The inflammation profiles of patients were similar except for moderately elevated levels of 4 cytokines for patients with GlcSph-reactive Igs. In summary, our study highlights the importance of analyzing clonal Igs separately from non-clonal Igs and shows that, if autoimmune responses to GlcSph are frequent in MGUS/SMM and MM, GlcSph presumably represents the initial pathogenic event for ~16% cases. Importantly, GlcSph-initiated MM appears to be a mild form of MM disease.

Prognostic Factors for Malignant Transformation in Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple Myeloma

2002 ◽  
Vol 20 (6) ◽  
pp. 1625-1634 ◽  
Author(s):  
Clara Cesana ◽  
Catherine Klersy ◽  
Luciana Barbarano ◽  
Anna Maria Nosari ◽  
Monica Crugnola ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Monoclonal Gammopathy ◽  
Extramedullary Plasmacytoma ◽  
Lymphocytic Leukemia ◽  
Cumulative Probability ◽  
Primary Amyloidosis ◽  
Smoldering Multiple Myeloma ◽  
Bence Jones Proteinuria ◽  
Undetermined Significance

PURPOSE: To evaluate the natural history of monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM), identify early predictors of evolution, and assess whether associated conditions correlate with disease progression. PATIENTS AND METHODS: A total of 1,231 consecutive patients with either MGUS (n = 1,104) or SMM (n = 127) diagnosed from July 1975 to March 1998 were included in the study. Cumulative survival probability and cumulative probability of transformation into lymphoproliferative disease were calculated by means of the Kaplan-Meier estimator. Univariate and multivariate Cox models were used to identify possible predictors of malignant evolution. RESULTS: Cumulative transformation probability at 10 and 15 years was 14% and 30%, respectively. At a median follow-up of 65 months (range, 12 to 239 months), 64 MGUS cases (5.8%) evolved to multiple myeloma (MM) (n = 43), extramedullary plasmacytoma (n = 1), primary amyloidosis (n = 1), Waldenström’s macroglobulinemia (n = 12), non-Hodgkin’s lymphoma (n = 6), and B-chronic lymphocytic leukemia (n = 1). At a median follow-up of 72 months (range, 12 to 247 months), 25 SMMs (19.7%) evolved to overt MM. A lower evolution risk was observed in MGUS than in SMM (P < .0001). Greater than 5% marrow plasmacytosis, detectable Bence Jones proteinuria, polyclonal serum immunoglobulin reduction, and high erythrocyte sedimentation rate (ESR) were independent factors influencing MGUS transformation. SMM progression correlated with greater than 10% marrow plasma cells, detectable Bence Jones proteinuria, and immunoglobulin (Ig) A isotype. Neither concomitant diseases nor immunosuppression correlated with progression. CONCLUSION: Careful evaluation of marrow plasmacytosis, urinary paraprotein, background immunoglobulins, ESR, and paraprotein isotype might help identify at presentation patients with benign monoclonal gammopathies requiring stricter monitoring.

scholarly journals Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma

Blood Reviews ◽  
2007 ◽  
Vol 21 (5) ◽  
pp. 255-265 ◽  
Author(s):  
S. Vincent Rajkumar ◽  
Martha Q. Lacy ◽  
Robert A. Kyle
Keyword(s):  
Multiple Myeloma ◽  
Monoclonal Gammopathy ◽  
Smoldering Multiple Myeloma ◽  
Undetermined Significance

Progression risk for MGUS and SMM

Blood ◽  
2007 ◽  
Vol 110 (7) ◽  
pp. 2226-2226 ◽  
Author(s):  
Philip Greipp
Keyword(s):  
Multiple Myeloma ◽  
Monoclonal Gammopathy ◽  
Smoldering Multiple Myeloma ◽  
Risk Of Progression ◽  
Progression Risk ◽  
Undetermined Significance

Patients with monoclonal gammopathy of undetermined significance (MGUS) are at continuous risk of progression. Each year, 1% progress, usually to active multiple myeloma (MM).1 Such patients must be monitored for life. Asymptomatic smoldering multiple myeloma (SMM) has an even greater risk of progression to MM. Recently reported strategies improve our ability to estimate the risk of MM in these patients.

scholarly journals Lack of Serologic Association Between Human Herpesvirus-8 Infection and Multiple Myeloma and Monoclonal Gammopathies of Undetermined Significance

1998 ◽  
Vol 90 (10) ◽  
pp. 781-781 ◽  
Author(s):  
Roberta Santarelli ◽  
Antonio Angeloni ◽  
Antonella Farina ◽  
Roberta Gonnella ◽  
Giuseppe Gentile ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Human Herpesvirus ◽  
Human Herpesvirus 8 ◽  
Herpesvirus 8 ◽  
Monoclonal Gammopathies ◽  
Undetermined Significance
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