What is involved in the long-term monitoring 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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Current guidelines suggest lifelong followup in patients with MGUS, so that malignant transformation can be identified early, before the onset of serious complications. [3, 29] Sigurdardottir et al reported significantly better overall survival in patients with MM who had prior knowledge of MGUS than in those without prior knowledge (median survival, 2.8 years versus 2.1 years, respectively; hazard ratio 1.86; 95% confidence index, 1.13-3.04; P = 0.01), suggesting that earlier treatment of MM leads to improved survival. [33]

Followup schedules in patients with MGUS can be based on risk stratification. Various risk prediction models exist, using a variety of risk factors (eg, serum M-protein level ≥1.5 g/dL, non-IgG M-protein, and abnormal free light chain [FLC] ratio; or ≥95% aberrant plasma cells in bone marrow and DNA aneuploidy on flow cytometry). [3, 29]


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