What is the role of drug treatment for 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

No treatment is recommended for patients with uncomplicated monoclonal gammopathy of undetermined significance (MGUS). However, polyneuropathy in IgM monoclonal gammopathy can be a disabling disorder. A prospective open-label trial by Niermeijer et al in 17 patients with IgM MGUS polyneuropathy found that treatment with rituximab (a chimeric anti-CD-20 monoclonal antibody) therapy was associated with improvement on three impairment measures and the presence of CD20 B-cell depletion in the bone marrow of all patients, and no serious adverse events. [38]

Niermeijer et al also reported that the response percentage rate with rituximab was comparable to that seen with intermittent cyclophosphamide/prednisone or fludarabine therapy, but with fewer side effects, and suggested that the presence of anti-MAG antibodies and a disease duration shorter than 10 years may predict treatment response. [38]


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