What are the recommendations for 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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Answer

European Myeloma Network guidelines recommend that followup consist of the following [3] :

  • History and physical examination
  • Serum M-protein electrophoresis
  • Complete blood cell count (CBC)
  • Serum creatinine assay
  • Serum calcium assay

The International Myeloma Working Group (IMWG) recommends followup serum protein electrophoresis for patients with MGUS 6 months after diagnosis, with subsequent followup depending on risk. The IMWG considers patients with IgG MGUS who have an M-protein level below 1.5 g/dL and a normal FLC ratio to be at low risk; if findings at 6 months are stable, subsequent follow-up can be every 2 to 3 years thereafter or when symptoms suggestive of a plasma cell malignancy arise. For patients with intermediate and high-risk MGUS, the IMWG recommends annual follow-up. [29]


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