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 RichardsonB Barlogie, P Greipp, R Vescio, I Turesson, J Westin, M Boccadoro, IMWG, Keith Wheatley

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541 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1121-7
Number of pages7
JournalLeukemia
Volume24
Issue number6
DOIs
Publication statusPublished - Jun 2010

Keywords

  • Disease Progression
  • Humans
  • Monoclonal Gammopathy of Undetermined Significance
  • Multiple Myeloma
  • Practice Guidelines as Topic
  • Prognosis
  • Risk Factors

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