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

Research output: Contribution to journalArticlepeer-review

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)1121-1127
Number of pages7
JournalLeukemia
Volume24
Issue number6
DOIs
Publication statusPublished - Jun 2010

Keywords

  • International Myeloma Working Group
  • MGUS
  • monoclonal gammopathy of undetermined significance
  • smoldering multiple myeloma

ASJC Scopus subject areas

  • Hematology
  • Cancer Research
  • Anesthesiology and Pain Medicine
  • Medicine(all)

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