Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management
R A Kyle, B G M Durie, S V Rajkumar, O Landgren, J Blade, G Merlini, N Kröger, H Einsele, D H Vesole, M Dimopoulos, J San Miguel, H Avet-Loiseau, R Hajek, W M Chen, K C Anderson, H Ludwig, P Sonneveld, S Pavlovsky, A Palumbo, P G Richardson, B Barlogie, P Greipp, R Vescio, I Turesson, J Westin, M Boccadoro, International Myeloma Working Group, Rafat Abonour, Ray Alexanian, Kenneth C Anderson, Michael Attal, Herve Avet-Loiseau, Ashraf Badros, Bart Barlogie, Dalsu Baris, Regis Batille, Meral Beksac, Andrew Belch, Bill Bensinger, P Leif Bergsagel, Jenny Bird, Joan Bladé, Mario Boccadoro, Michele Cavo, Asher Chanan-Khan, Wen Ming Chen, Tony Child, James Chim, Wee-Joo Chng, Ray Comenzo, John Crowley, William Dalton, Faith Davies, Cármino de Souza, Michel Delforge, Meletios Dimopoulos, Angela Dispenzieri, Brian G M Durie, Johannes Drach, Hermann Einsele, Theirry Facon, Dorotea Fantl, Jean-Paul Fermand, Rafael Fonseca, Gösta Gahrton, Ramon Garcia-Sanz, Christina Gasparetto, Morie Gertz, John Gibson, Sergio Giralt, Hartmut Goldschmidt, Philip Greipp, Roman Hajek, Izhar Hardan, Jean-Luc Harousseau, Hiroyuki Hata, Yutaka Hattori, Tom Heffner, Joy Ho, Vania Hungria, Shinsuke Ida, Peter Jacobs, Sundar Jagannath, Hou Jian, Douglas Joshua, Artur Jurczyszyn, Michio Kawano, Nicolaus Kröger, Shaji Kumar, Robert A Kyle, Juan Lahuerta, Ola Landgren, Jacob Laubach, Jae Hoon Lee, Xavier LeLeu, Suzanne Lentzsch, Henk Lokhorst, Sagar Lonial, Heinz Ludwig, Angelo Maiolino, Maria Mateos, Jayesh Mehta, Ulf-Henrik Mellqvist, GiamPaolo Merlini, Joseph Mikhael, Angelina Rodriquez Morales, Philippe Moreau, Gareth Morgan, Nikhil Munshi, Ruben Niesvizky, Amara Nouel, Yana Novis, Robert Orlowski, Antonio Palumbo, Santiago Pavlovsky, Linda Pilarski, Raymond Powles, S Vincent Rajkumar, Donna Reece, Tony Reiman, Paul G Richardson, David Roodman, Laura Rosinol, Jesus San Miguel, Orhan Sezer, Jatin J Shah, John Shaughnessy, Kazuyuki Shimizu, Chaim Shustik, David Siegel, Seema Singhal, Pieter Sonneveld, Andrew Spencer, Edward Stadtmauer, Keith Stewart, Evangelos Terpos, Patrizia Tosi, Guido Tricot, Ingemar Turesson, Karin Vanderkerken, Brian Van Ness, Ivan Van Riet, Robert Vescio, David Vesole, Anders Waage, Michael Wang, Donna Weber, Jan Westin, Keith Wheatley, Dina B Yehuda, Jeffrey Zonder, R A Kyle, B G M Durie, S V Rajkumar, O Landgren, J Blade, G Merlini, N Kröger, H Einsele, D H Vesole, M Dimopoulos, J San Miguel, H Avet-Loiseau, R Hajek, W M Chen, K C Anderson, H Ludwig, P Sonneveld, S Pavlovsky, A Palumbo, P G Richardson, B Barlogie, P Greipp, R Vescio, I Turesson, J Westin, M Boccadoro, International Myeloma Working Group, Rafat Abonour, Ray Alexanian, Kenneth C Anderson, Michael Attal, Herve Avet-Loiseau, Ashraf Badros, Bart Barlogie, Dalsu Baris, Regis Batille, Meral Beksac, Andrew Belch, Bill Bensinger, P Leif Bergsagel, Jenny Bird, Joan Bladé, Mario Boccadoro, Michele Cavo, Asher Chanan-Khan, Wen Ming Chen, Tony Child, James Chim, Wee-Joo Chng, Ray Comenzo, John Crowley, William Dalton, Faith Davies, Cármino de Souza, Michel Delforge, Meletios Dimopoulos, Angela Dispenzieri, Brian G M Durie, Johannes Drach, Hermann Einsele, Theirry Facon, Dorotea Fantl, Jean-Paul Fermand, Rafael Fonseca, Gösta Gahrton, Ramon Garcia-Sanz, Christina Gasparetto, Morie Gertz, John Gibson, Sergio Giralt, Hartmut Goldschmidt, Philip Greipp, Roman Hajek, Izhar Hardan, Jean-Luc Harousseau, Hiroyuki Hata, Yutaka Hattori, Tom Heffner, Joy Ho, Vania Hungria, Shinsuke Ida, Peter Jacobs, Sundar Jagannath, Hou Jian, Douglas Joshua, Artur Jurczyszyn, Michio Kawano, Nicolaus Kröger, Shaji Kumar, Robert A Kyle, Juan Lahuerta, Ola Landgren, Jacob Laubach, Jae Hoon Lee, Xavier LeLeu, Suzanne Lentzsch, Henk Lokhorst, Sagar Lonial, Heinz Ludwig, Angelo Maiolino, Maria Mateos, Jayesh Mehta, Ulf-Henrik Mellqvist, GiamPaolo Merlini, Joseph Mikhael, Angelina Rodriquez Morales, Philippe Moreau, Gareth Morgan, Nikhil Munshi, Ruben Niesvizky, Amara Nouel, Yana Novis, Robert Orlowski, Antonio Palumbo, Santiago Pavlovsky, Linda Pilarski, Raymond Powles, S Vincent Rajkumar, Donna Reece, Tony Reiman, Paul G Richardson, David Roodman, Laura Rosinol, Jesus San Miguel, Orhan Sezer, Jatin J Shah, John Shaughnessy, Kazuyuki Shimizu, Chaim Shustik, David Siegel, Seema Singhal, Pieter Sonneveld, Andrew Spencer, Edward Stadtmauer, Keith Stewart, Evangelos Terpos, Patrizia Tosi, Guido Tricot, Ingemar Turesson, Karin Vanderkerken, Brian Van Ness, Ivan Van Riet, Robert Vescio, David Vesole, Anders Waage, Michael Wang, Donna Weber, Jan Westin, Keith Wheatley, Dina B Yehuda, Jeffrey Zonder
Abstract
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.
Conflict of interest statement
Conflict of interest
The authors declare no conflict of interest.
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Source: PubMed