Monoclonal gammopathy of undetermined significance classification

Jump to navigation Jump to search

Monoclonal gammopathy of undetermined significance Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Monoclonal gammopathy of undetermined significance from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Monoclonal gammopathy of undetermined significance classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Monoclonal gammopathy of undetermined significance classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Monoclonal gammopathy of undetermined significance classification

on Monoclonal gammopathy of undetermined significance classification

Monoclonal gammopathy of undetermined significance classification in the news

Blogs on Monoclonal gammopathy of undetermined significance classification

Directions to Hospitals Treating Monoclonal gammopathy of undetermined significance

Risk calculators and risk factors for Monoclonal gammopathy of undetermined significance classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2] Muhammad Saad, M.B.B.S.[3]

Overview

Monoclonal gammopathy of undetermined significance (MGUS) may be classified according to cytogenetic differences into subtypes/groups based on translocations. There is no established system for the staging of monoclonal gammopathy of undetermined significance (MGUS).

Classification

MGUS is typically divided into non-IgM MGUS, IgM MGUS, and light chain MGUS as described in the following flowchart:[1][2][3][4]

 
 
 
 
 
 
 
 
 
 
 
 
Non IgM MGUS:

1. <10%BM plasma cells
2. Monoclonal protein <3.0g/dL
3. No symptoms
 
Smoldering MM:

1. No symptoms
2. >10%BM plasma cells
 
MM:

1. Symptoms
2. >10%BM plasma cells
AL Amyloidosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IgM MGUS:

1. <10%BM lymphoplasmacytic cells
2. Monoclonal protein <3.0g/dL
3. No symptoms
 
Smoldering WM:

1. No symptoms
2. >10%BM lymphoplasmacytic cells
 
WM:

1. Symptoms
2. >10%BM lymphoplasmacytic cells
AL Amyloidosis
IgM MM
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Clonal plasma cell or B lymphocyte
 
 
 
 
Light chain MGUS:

1. <10%BM plasma cells
2. Abnormal FLC ratio
3. No monoclonal protein
4. No symptoms
 
Light chain MM:

1. Symptoms
2. >10%BM plasma cells
AL Amyloidosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Monoclonal gammopathy of clinical significance :

1. Presence of monoclonal protein or FLC
2. Symptoms attributable to presence of monoclonal protein
3. Diagnostic criteria of MM not met
 
 
 
 
 

Monoclonal gammopathy of undetermined significance (MGUS) may be classified according to cytogenetic differences into the following subtypes/groups:[5]

Abnormalities in cytogenes Affected genes
IgH translocation:
t(11;14), q(13;32) cyclin D1
t(4;14)(p16;q32) FGFR-3, and MMSET
t(14;16)(q32;q23) C-MAF
t(6;14)(q32;q11) MAFB
IgH non-translocated :
Hyper diploid Numerous

References

  1. Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos MV, Kumar S, Hillengass J, Kastritis E, Richardson P, Landgren O, Paiva B, Dispenzieri A, Weiss B, LeLeu X, Zweegman S, Lonial S, Rosinol L, Zamagni E, Jagannath S, Sezer O, Kristinsson SY, Caers J, Usmani SZ, Lahuerta JJ, Johnsen HE, Beksac M, Cavo M, Goldschmidt H, Terpos E, Kyle RA, Anderson KC, Durie BG, Miguel JF (November 2014). "International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma". Lancet Oncol. 15 (12): e538–48. doi:10.1016/S1470-2045(14)70442-5. PMID 25439696.
  2. Gertz MA (February 2023). "Waldenström macroglobulinemia: 2023 update on diagnosis, risk stratification, and management". Am J Hematol. 98 (2): 348–358. doi:10.1002/ajh.26796. PMID 36588395 Check |pmid= value (help).
  3. Kyle RA, Durie BG, Rajkumar SV, Landgren O, Blade J, Merlini G, Kröger N, Einsele H, Vesole DH, Dimopoulos M, San Miguel J, Avet-Loiseau H, Hajek R, Chen WM, Anderson KC, Ludwig H, Sonneveld P, Pavlovsky S, Palumbo A, Richardson PG, Barlogie B, Greipp P, Vescio R, Turesson I, Westin J, Boccadoro M (June 2010). "Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management". Leukemia. 24 (6): 1121–7. doi:10.1038/leu.2010.60. PMC 7020664 Check |pmc= value (help). PMID 20410922.
  4. Gertz MA, Dispenzieri A (July 2020). "Systemic Amyloidosis Recognition, Prognosis, and Therapy: A Systematic Review". JAMA. 324 (1): 79–89. doi:10.1001/jama.2020.5493. PMID 32633805 Check |pmid= value (help).
  5. Rajkumar SV, Kyle RA, Buadi FK (October 2010). "Advances in the diagnosis, classification, risk stratification, and management of monoclonal gammopathy of undetermined significance: implications for recategorizing disease entities in the presence of evolving scientific evidence". Mayo Clin. Proc. 85 (10): 945–8. doi:10.4065/mcp.2010.0520. PMC 2947967. PMID 20884827.

Template:WH Template:WS