TY - JOUR
T1 - The clinical relevance and management of monoclonal gammopathy of undetermined significance and related disorders
T2 - recommendations from the European Myeloma Network
AU - van de Donk, Niels W C J
AU - Palumbo, Antonio
AU - Johnsen, Hans Erik
AU - Engelhardt, Monika
AU - Gay, Francesca
AU - Gregersen, Henrik
AU - Hajek, Roman
AU - Kleber, Martina
AU - Ludwig, Heinz
AU - Morgan, Gareth
AU - Musto, Pellegrino
AU - Plesner, Torben
AU - Sezer, Orhan
AU - Terpos, Evangelos
AU - Waage, Anders
AU - Zweegman, Sonja
AU - Einsele, Hermann
AU - Sonneveld, Pieter
AU - Lokhorst, Henk M
AU - European Myeloma Network
N1 - Copyright© Ferrata Storti Foundation.
PY - 2014/6
Y1 - 2014/6
N2 - 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; light-chain 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.
AB - 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; light-chain 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.
U2 - 10.3324/haematol.2013.100552
DO - 10.3324/haematol.2013.100552
M3 - Journal article
C2 - 24658815
SN - 0390-6078
VL - 99
SP - 984
EP - 996
JO - Haematologica
JF - Haematologica
IS - 6
ER -