scholarly journals Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple Myeloma

2010 ◽  
Vol 5 (2) ◽  
pp. 62-69 ◽  
Author(s):  
Robert A. Kyle ◽  
S. Vincent Rajkumar
Keyword(s):  
Multiple Myeloma ◽  
Monoclonal Gammopathy ◽  
Smoldering Multiple Myeloma ◽  
Undetermined Significance

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.

Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma: biological insights and early treatment strategies

Hematology ◽  
2013 ◽  
Vol 2013 (1) ◽  
pp. 478-487 ◽  
Author(s):  
Ola Landgren
Keyword(s):  
Multiple Myeloma ◽  
Patient Outcomes ◽  
Early Treatment ◽  
Monoclonal Gammopathy ◽  
Treatment Strategies ◽  
Precursor State ◽  
The Past ◽  
Smoldering Multiple Myeloma ◽  
Remarkable Progress ◽  
Undetermined Significance

Abstract After decades of virtually no progress, multiple myeloma survival has improved significantly in the past 10 years. Indeed, multiple myeloma has perhaps seen more remarkable progress in treatment and patient outcomes than any other cancer during the last decade. Recent data show that multiple myeloma is consistently preceded by a precursor state (monoclonal gammopathy of undetermined significance [MGUS]/smoldering multiple myeloma [SMM]). This observation provides a framework for prospective studies focusing on transformation from precursor disease to multiple myeloma and for the development of treatment strategies targeting “early myeloma.” This review discusses current biological insights in MGUS/SMM, provides an update on clinical management, and discusses how the integration of novel biological markers, molecular imaging, and clinical monitoring of MGUS/SMM could facilitate the development of early treatment strategies for high-risk SMM (early myeloma) patients in the future.

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