Determine risk of malignant progression to myleoma or lymphoproliferative disorder.
Patients with monoclonal gammopathy of undetermined significance (MGUS) have an increased risk of developing a hematologic malignancy, most often multiple myeloma from IgG and IgA MGUS, and other malignant lymphoproliferative disorders from IgM MGUS. A previous large study from the Mayo Clinic of patients in Minnesota with MGUS detected an overall risk of progression of approximately 1% per year (Kyle 2002). This model from the same Minnesota population proposes a risk-stratification model based on serum M-protein concentration, type of paraprotein, and presence of an abnormal serum free kappa:lambda light chain ratio (Rajkumar 2005). This risk-stratification model may be useful in identifying MGUS patients with a high risk of progression as candidates for closer supervision and potential clinical trial strategies. It may also prove useful in identifying patients with a very low risk of malignant transformation and less intensive follow-up (BCSH MGUS Guidelines), although surveillance strategies based on this model require prospective study.
Rajkumar et al.
Kyle et al.
Patients with monoclonal gammopathy of undetermined significance (MGUS) have an increased risk of developing a hematologic malignancy, most often multiple myeloma from IgG and IgA MGUS, and other malignant lymphoproliferative disorders from IgM MGUS. A previous large study from the Mayo Clinic of patients in Minnesota with MGUS detected an overall risk of progression of approximately 1% per year (Kyle 2002). This model from the same Minnesota population proposes a risk-stratification model based on serum M-protein concentration, type of paraprotein, and presence of an abnormal serum free kappa:lambda light chain ratio (Rajkumar 2005). This risk-stratification model may be useful in identifying MGUS patients with a high risk of progression as candidates for closer supervision and potential clinical trial strategies. It may also prove useful in identifying patients with a very low risk of malignant transformation and less intensive follow-up (BCSH MGUS Guidelines), although surveillance strategies based on this model require prospective study.
Rajkumar et al.
Kyle et al.
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