MGUS poses lifelong risk of progression to multiple myeloma

Volume 7, Issue 2, 2018

Summary

Patients should be checked for progression and receive all routine preventive services as they age.

Photograph of S. Vincent Rajkumar, M.D.

S. Vincent Rajkumar, M.D.

Patients with monoclonal gammopathy of undetermined significance are at risk of the condition progressing to multiple myeloma or a related cancer, even after 30 years of stability. These are the findings of a study by Mayo Clinic researchers published in the New England Journal of Medicine on Jan. 18, 2018.

Monoclonal gammopathy of undetermined significance (MGUS) is a condition in which an abnormal protein, known as monoclonal protein, is found in the blood. Monoclonal gammopathy of undetermined significance usually causes no problems, but it might progress over time into multiple myeloma, a type of blood cancer.

"Monoclonal gammopathy of undetermined significance is present in more than 3 percent of the general population age 50 and older," said S. Vincent Rajkumar, M.D., a Mayo Clinic hematologist in Rochester, Minnesota, and senior author of the multiple myeloma study. "In some cases, people with monoclonal gammopathy of undetermined significance go on to develop multiple myeloma."

In the study, Dr. Rajkumar and his colleagues found that the overall risk of progression to multiple myeloma or a related disorder is relatively small, at 1 percent each year. However, the risk persists indefinitely. Researchers also noted that the risk of myeloma or a related cancer was relatively small compared with other general causes of death. As a result, they recommend that patients who are followed for MGUS be checked for the presence or absence of progression and also receive all other routine preventive services appropriate for patients as they age.

"We also found that patients with monoclonal gammopathy of undetermined significance had shorter survival than comparable people without the condition, which raises the possibility there may be other disorders associated with monoclonal gammopathy of undetermined significance that still need further study," Dr. Rajkumar said.

For the multiple myeloma study, researchers studied 1,384 patients with two major types of monoclonal gammopathy of undetermined significance: IgM monoclonal gammopathy of undetermined significance and non-IgM monoclonal gammopathy of undetermined significance, and associated risk factors that health professionals use to counsel patients.

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