Monoclonal gammopathy of undetermined significance medical therapy: Difference between revisions
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{{Monoclonal gammopathy of undetermined significance }} | {{Monoclonal gammopathy of undetermined significance }} | ||
{{CMG}} {{ | {{CMG}} ; {{AE}} {{OK}}{{shyam}} | ||
==Overview== | ==Overview== | ||
There is no specific treatment for [[monoclonal gammopathy of undetermined significance]]; the mainstay of therapy is active surveillance and supportive care. The goal is to detect other plasma cell dyscrasias at an early time point such that corrective intervention can be undertaken. Trials using lenalidomide and bisphosphonates are been conducted to determine whether they decrease the progression of the disease both for MGUS and multiple myeloma. | There is no specific treatment for [[monoclonal gammopathy of undetermined significance]]; the mainstay of therapy is active surveillance and supportive care. The goal is to detect other [[Plasma cell disorder|plasma cell dyscrasias]] at an early time point such that corrective intervention can be undertaken. Trials using [[lenalidomide]] and [[bisphosphonates]] are been conducted to determine whether they decrease the progression of the disease both for MGUS and [[multiple myeloma]]. | ||
==Medical Therapy== | ==Medical Therapy== | ||
There is no specific treatment for [[monoclonal gammopathy of undetermined significance]]. The mainstay of therapy is active surveillance and supportive care. A typical management regimen includes once yearly blood checks, including assessment of: | There is no specific treatment for [[monoclonal gammopathy of undetermined significance]]. The mainstay of therapy is active surveillance and supportive care. A typical management regimen includes once yearly blood checks, including assessment of: | ||
*[[Complete blood count]] | *[[Complete blood count]] | ||
* | *Complete metabolic panel | ||
*[[Serum protein electrophoresis]] | *[[Serum protein electrophoresis]] | ||
*[[Serum free light chains]]<ref name="pmid19673884">{{cite journal |vauthors=Bird J, Behrens J, Westin J, Turesson I, Drayson M, Beetham R, D'Sa S, Soutar R, Waage A, Gulbrandsen N, Gregersen H, Low E |title=UK Myeloma Forum (UKMF) and Nordic Myeloma Study Group (NMSG): guidelines for the investigation of newly detected M-proteins and the management of monoclonal gammopathy of undetermined significance (MGUS) |journal=Br. J. Haematol. |volume=147 |issue=1 |pages=22–42 |date=October 2009 |pmid=19673884 |doi=10.1111/j.1365-2141.2009.07807.x |url=}}</ref> | *[[Serum]] [[Light chain|free light chains]]<ref name="pmid19673884">{{cite journal |vauthors=Bird J, Behrens J, Westin J, Turesson I, Drayson M, Beetham R, D'Sa S, Soutar R, Waage A, Gulbrandsen N, Gregersen H, Low E |title=UK Myeloma Forum (UKMF) and Nordic Myeloma Study Group (NMSG): guidelines for the investigation of newly detected M-proteins and the management of monoclonal gammopathy of undetermined significance (MGUS) |journal=Br. J. Haematol. |volume=147 |issue=1 |pages=22–42 |date=October 2009 |pmid=19673884 |doi=10.1111/j.1365-2141.2009.07807.x |url=}}</ref> | ||
=== Anti-resorptive therapy === | === Anti-resorptive therapy === | ||
Vitamin D and calcium can be given as anti-resorptive therapy.<ref name="pmid20507313">{{cite journal |vauthors=Berenson JR, Anderson KC, Audell RA, Boccia RV, Coleman M, Dimopoulos MA, Drake MT, Fonseca R, Harousseau JL, Joshua D, Lonial S, Niesvizky R, Palumbo A, Roodman GD, San-Miguel JF, Singhal S, Weber DM, Zangari M, Wirtschafter E, Yellin O, Kyle RA |title=Monoclonal gammopathy of undetermined significance: a consensus statement |journal=Br. J. Haematol. |volume=150 |issue=1 |pages=28–38 |date=July 2010 |pmid=20507313 |doi=10.1111/j.1365-2141.2010.08207.x |url=}}</ref> | [[Vitamin D]] and [[calcium]] can be given as anti-resorptive therapy.<ref name="pmid20507313">{{cite journal |vauthors=Berenson JR, Anderson KC, Audell RA, Boccia RV, Coleman M, Dimopoulos MA, Drake MT, Fonseca R, Harousseau JL, Joshua D, Lonial S, Niesvizky R, Palumbo A, Roodman GD, San-Miguel JF, Singhal S, Weber DM, Zangari M, Wirtschafter E, Yellin O, Kyle RA |title=Monoclonal gammopathy of undetermined significance: a consensus statement |journal=Br. J. Haematol. |volume=150 |issue=1 |pages=28–38 |date=July 2010 |pmid=20507313 |doi=10.1111/j.1365-2141.2010.08207.x |url=}}</ref> | ||
=== Peripheral neuropathy === | === Peripheral neuropathy === | ||
Corticosteroids may be helpful with peripheral neuropathy. Gabapentin can be considered also. | [[Corticosteroids]] may be helpful with [[peripheral neuropathy]]. [[Gabapentin]] can be considered also. | ||
=== Advances === | === Advances === | ||
Latest revision as of 14:00, 24 October 2019
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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]Shyam Patel [3]
Overview
There is no specific treatment for monoclonal gammopathy of undetermined significance; the mainstay of therapy is active surveillance and supportive care. The goal is to detect other plasma cell dyscrasias at an early time point such that corrective intervention can be undertaken. Trials using lenalidomide and bisphosphonates are been conducted to determine whether they decrease the progression of the disease both for MGUS and multiple myeloma.
Medical Therapy
There is no specific treatment for monoclonal gammopathy of undetermined significance. The mainstay of therapy is active surveillance and supportive care. A typical management regimen includes once yearly blood checks, including assessment of:
- Complete blood count
- Complete metabolic panel
- Serum protein electrophoresis
- Serum free light chains[1]
Anti-resorptive therapy
Vitamin D and calcium can be given as anti-resorptive therapy.[2]
Peripheral neuropathy
Corticosteroids may be helpful with peripheral neuropathy. Gabapentin can be considered also.
Advances
Trials using lenalidomide and bisphosphonates are begin run to determine whether they decrease the progression of the disease both for MGUS and multiple myeloma.[3][4][5]
References
- ↑ Bird J, Behrens J, Westin J, Turesson I, Drayson M, Beetham R, D'Sa S, Soutar R, Waage A, Gulbrandsen N, Gregersen H, Low E (October 2009). "UK Myeloma Forum (UKMF) and Nordic Myeloma Study Group (NMSG): guidelines for the investigation of newly detected M-proteins and the management of monoclonal gammopathy of undetermined significance (MGUS)". Br. J. Haematol. 147 (1): 22–42. doi:10.1111/j.1365-2141.2009.07807.x. PMID 19673884.
- ↑ Berenson JR, Anderson KC, Audell RA, Boccia RV, Coleman M, Dimopoulos MA, Drake MT, Fonseca R, Harousseau JL, Joshua D, Lonial S, Niesvizky R, Palumbo A, Roodman GD, San-Miguel JF, Singhal S, Weber DM, Zangari M, Wirtschafter E, Yellin O, Kyle RA (July 2010). "Monoclonal gammopathy of undetermined significance: a consensus statement". Br. J. Haematol. 150 (1): 28–38. doi:10.1111/j.1365-2141.2010.08207.x. PMID 20507313.
- ↑ Pozzi S, Raje N (2011). "The role of bisphosphonates in multiple myeloma: mechanisms, side effects, and the future". Oncologist. 16 (5): 651–62. doi:10.1634/theoncologist.2010-0225. PMC 3228190. PMID 21493759.
- ↑ Mateos MV, Hernández MT, Giraldo P, de la Rubia J, de Arriba F, López Corral L, Rosiñol L, Paiva B, Palomera L, Bargay J, Oriol A, Prosper F, López J, Olavarría E, Quintana N, García JL, Bladé J, Lahuerta JJ, San Miguel JF (August 2013). "Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma". N. Engl. J. Med. 369 (5): 438–47. doi:10.1056/NEJMoa1300439. PMID 23902483.
- ↑ Mahindra A, Pozzi S, Raje N (September 2012). "Clinical trials of bisphosphonates in multiple myeloma". Clin Adv Hematol Oncol. 10 (9): 582–7. PMID 23073123.