What is the role of bone marrow exam in the workup of 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

Bone marrow examination is recommended as part of the diagnostic workup for all patients with IgA and IgM M-proteins. In patients with apparent IgG MGUS, bone marrow examination is typically not recommended unless the serum M-protein level is greater than 1.5 g/dL or end-organ damage is evident. [3]

Ng et al reported improved quantification of marrow involvement through the use of CD138 immunostaining of bone marrow trephine specimens. [33] For the importance of immunophenotypic analysis, see Jerez et al. [34]


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