The clinical relevance and management of monoclonal gammopathy of undetermined significance and related disorders: Recommendations from the European Myeloma Network

Niels W C J van de Donk, Antonio Palumbo, Hans Erik Johnsen, Monika Engelhardt, Francesca Gay, Henrik Gregersen, Roman Hajek, Martina Kleber, Heinz Ludwig, Gareth Morgan, Pellegrino Musto, Torben Plesner, Orhan Sezer, Evangelos Terpos, Anders Waage, Sonja Zweegman, Hermann Einsele, Pieter Sonneveld, Henk M. Lokhorst

Research output: Contribution to journalArticlepeer-review

Abstract

Monoclonal gammopathy of undetermined significance is one of the most common pre-malignant disorders. IgG and IgA monoclonal gammopathy of undetermined significance are precursor conditions of multiple myeloma; lightchain monoclonal gammopathy of undetermined significance of light-chain multiple myeloma; and IgM monoclonal gammopathy of undetermined significance of Waldenström's macroglobulinemia and other lymphoproliferative disorders. Clonal burden, as determined by bone marrow plasma cell percentage or M-protein level, as well as biological characteristics, including heavy chain isotype and light chain production, are helpful in predicting risk of progression of monoclonal gammopathy of undetermined significance to symptomatic disease. Furthermore, alterations in the bone marrow microenvironment of monoclonal gammopathy of undetermined significance patients result in an increased risk of venous and arterial thrombosis, infections, osteoporosis, and bone fractures. In addition, the small clone may occasionally be responsible for severe organ damage through the production of a monoclonal protein that has autoantibody activity or deposits in tissues. These disorders are rare and often require therapy directed at eradication of the underlying plasma cell or lymphoplasmacytic clone. In this review, we provide an overview of the clinical relevance of monoclonal gammopathy of undetermined significance. We also give general recommendations of how to diagnose and manage patients with monoclonal gammopathy of undetermined significance.

Original languageEnglish
Pages (from-to)984-996
Number of pages13
JournalHaematologica
Volume99
Issue number6
DOIs
Publication statusPublished - Jun 1 2014

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

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