Hematology and Oncology Book




Monoclonal Gammopathy of Undetermined Significance

Aka: Monoclonal Gammopathy of Undetermined Significance, MGUS
  1. Epidemiology
    1. Present in 2% of patients over age 50
    2. Ultimately responsible for 20% of Multiple Myeloma cases after progression
  2. Evaluation: Factors suggesting higher risk of Multiple Myeloma progression
    1. Criteria
      1. Elevated M Protein Level >1.5 g/dl
      2. Non-IgG MGUS
      3. Abnormal free light chain ratio
    2. Interpretation
      1. Risk of Multiple Myeloma is 58% in 20 years if all 3 factors present
  3. Monitoring
    1. Repeat labs every 6-12 months to monitor for progression to Multiple Myeloma
  4. Course
    1. Progresses to Multiple Myeloma in 1% of cases per year

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