What is the risk of progression to multiple myeloma (MM) from monoclonal gammopathy of undetermined significance (MGUS)?

Updated: Sep 07, 2018
  • Author: Suzanne R Fanning, DO; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The risk of progression to MM or other lymphoproliferative disorder is present at a constant rate throughout the remainder of a patient's life. This observation suggests that the second event responsible for progression is a random event and not cumulative.

In patients with symptomatic MM, the development of a new monoclonal protein following therapy is associated with better outcomes. A study by Mullikin et al in patients with biclonal gammopathy of undetermined significance found that the rate of progression was similar to that seen in MGUS with one monoclonal protein, suggesting that multiple monoclonal proteins do not clinically impact one another. Of the 393 patients in the study, six progressed to smoldering MM, 11 to MM, three to amyloidosis, and two to Waldenström macroglobulinemia. [10]


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