Monoclonal gammopathy of undetermined significance (patient information)
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2]
Overview
People with monoclonal gammopathy of undetermined significance generally don't experience signs or symptoms. Some people may experience a rash or nerve problems, such as numbness or tingling. MGUS is usually detected by chance when you have a blood test for another condition. MGUS occurs when abnormal plasma cells produce M protein. The protein isn't harmful for most people. But if too much M protein accumulates, it crowds out healthy cells in your bone marrow and can damage other tissues in your body. There is no specific treatment options for monoclonal gammopathy of undetermined significance ; the mainstay of therapy is supportive care, keep an eye and delay the progression to other plasma dyscrasias.Trials using lenalidomide and bisphosphonates are been run to determine whether they decrease they progression of the disease both for MGUS and multiple myeloma. Vitamin D and calcium can be given as anti-resorptive therapy. Corticosteroids may be help with peripheral neuropathy. Complications include fractures specially in lumbar vertebrae, thromboembolic phenomena, hypercoaguable state, and development of secondary cancers eg. acute myeloid leukemia and myelodysplastic syndromes.
What are the Symptoms of monoclonal gammopathy of undetermined significance
People with monoclonal gammopathy of undetermined significance generally don't experience signs or symptoms. Some people may experience a rash or nerve problems, such as numbness or tingling. MGUS is usually detected by chance when you have a blood test for another condition.
What Causes monoclonal gammopathy of undetermined significance
The most common causes of monoclonal gammopathy of undetermined significance classification are mutations in genes like:
- Cyclin D1
- FGFR-3
- MMSET
- C-MAF
- MAFB.
Who is at Highest Risk?
Patients having the following lab values are at increased risk:
- M-protein > 1.5 g/dL (15 g/L)
- Non-IgG isotype (IgA or IgM)
- FLC Ratio < 0.26 or > 1.65
Diagnosis
The diagnosis consists of:
- M-protein < 3 g/dL (30 g/L)
- Clonal bone marrow plasma cells < 10% AND/OR
- Urine monoclonal protein < 500 mg
When to Seek Urgent Medical Care?
Call your health care provider if you develop symptoms of MGUS.
Treatment Options
There is no specific treatment options for monoclonal gammopathy of undetermined significance ; the mainstay of therapy is supportive care, keep an eye and delay the progression to other plasma dyscrasias.Trials using lenalidomide and bisphosphonates are been run to determine whether they decrease they progression of the disease both for MGUS and multiple myeloma. Vitamin D and calcium can be given as anti-resorptive therapy. Corticosteroids may be help with peripheral neuropathy.
Where to find Medical Care for ?
Prevention
There are no established measures for the primary prevention of MGUS
What to Expect (Outlook/Prognosis)?
MGUS, is considered as a pre-malignant condition, and its transformation to multiple myeloma. However, as it mostly occurs in elderly, and its slow rate of progression, only a small proportion of people go on to develop a hematological malignancy. In patients with MGUS, although the actuarial risk of myeloma at 25 years of follow-up is 30%, the actual risk (when competing causes of death are taken into account) is only 11%.
Possible Complications
The following are frequent complications of Monoclonal gammopathy of undetermined significance
- Fractures specially in lumbar vertebrae
- Thromboembolic phenomena
- Hypercoaguable state
- Development of secondary cancers eg. acute myeloid leukemia and myelodysplastic syndromes