Materiały źródłowe

• #1 Treatment of Patients with Monoclonal Gammopathy of Clinical Significance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8533809/

  Monoclonal gammopathy of undetermined significance (MGUS) is defined as the presence of a monoclonal protein (M-protein) produced by a small amount of plasma cells. The majority of patients remain asymptomatic; however, a fraction of them develop clinical manifestations related to the monoclonal gammopathy despite not fulfilling criteria of multiple myeloma or other lymphoproliferative disorder. These patients constitute an emerging clinical issue coined as monoclonal gammopathy of clinical significance (MGCS). The mechanisms involved are poorly understood, and literature is scarce regarding management. The clinical spectrum involves symptoms related to renal, neurologic, skin, ocular, or bleeding manifestations, requiring a multidisciplinary approach. Treatment strategies rely on the basis of symptomatic disease and the M-protein isotype. In this review, we focus on MGCS other than renal, as the latter was earliest recognized and better known. We review the literature and discuss management from diagnosis to treatment based on illustrative cases from daily practice.

• #2 Monoclonal Gammopathy of Undetermined Significance – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507880/

  Treatment is usually not recommended for patients with MGUS. As there is a risk of progression to lymphoproliferative malignancy long-term follow-up is advised. […] If a patient has an IgM M-protein, bone marrow biopsy and computed tomography (CT) scanning of the abdomen may be helpful in detecting Waldenstrm macroglobulinemia or other lymphoproliferative disorders. […] MGUS-associated neuropathies are usually not treated, except in the case of a disabling IgM monoclonal gammopathy or IgG/IgA MGUS associated with chronic inflammatory demyelinating neuropathy (CIDP). About 80% of patients with IgG/IgA MGUS CIDP respond to one of the typical CIDP treatments and some patients stabilize without therapy. MGUS patients with associated osteopenia or osteoporosis may benefit from treatment with intravenous bisphosphonates.

• #3 Monoclonal gammopathy of undetermined significance (MGUS) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mgus/symptoms-causes/syc-20352362

  People who have high amounts of this protein in the blood need regular checkups. That’s so they can get earlier treatment if the condition gets worse. If it doesn’t get worse, MGUS doesn’t need treatment. […] Each year, about 1% of people with MGUS get certain types of blood cancers or other serious diseases, such as: […] Clinical course and management of monoclonal gammopathy of undetermined significance.

• #4 Monoclonal Gammopathy of Undetermined Significance (MGUS) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/multiple-myeloma/other-plasma-cell-diseases/monoclonal-gammopathy-undetermined-significance

  Monoclonal gammopathy of undetermined significance (MGUS) is not cancer. Theres a small risk it can become cancer. Out of every 100 people with MGUS, each year, 1 or 2 of them will get cancer from MGUS. […] If you have MGUS, your protein levels should be monitored through regular blood tests. You will not need treatment for MGUS as long as the level of m-protein does not rise. […] They will watch to see if MGUS becomes another blood disease. If that happens, your MSK doctors can treat plasma cell disorders or multiple myeloma.

• #5 Monoclonal Gammopathies of Undetermined Significance (MGUS) Treatment & Management: Approach Considerations, Long-Term Monitoring

  https://emedicine.medscape.com/article/204297-treatment

  No treatment is recommended for patients with MGUS. […] Long-term follow-up is generally advised, given the risk of progression to lymphoproliferative malignancy. […] MGUS-associated neuropathies are generally not treated, except in the case of a disabling IgM monoclonal gammopathy or IgG/A MGUS associated with chronic inflammatory demyelinating neuropathy (CIDP). About 80% of patients with IgG/A MGUS CIDP respond to one of the typical CIDP treatments and some patients stabilize without therapy. […] The intensity of follow-up in patients with MGUS is guided by risk stratification. […] Current guidelines suggest lifelong followup in patients with MGUS, so that malignant transformation can be identified early, before the onset of serious complications. […] 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. […] With IgM MGUS, which poses a high risk for malignant progression, some experts recommend more intensive follow-up, with twice-annual visits. […] The European Myeloma Network advises that for low-risk MGUS, follow-up at 6 months and every 12 years thereafter can be justified.

• #6 Monoclonal gammopathy of undetermined significance | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/multiple-myeloma/what-is-multiple-myeloma/monoclonal-gammopathy-of-undetermined-significance

  MGUS is usually found when doing routine blood work or if multiple myeloma or Waldenstrom macroglobulinemia is suspected. […] When you are diagnosed with MGUS, you will be closely monitored (watched) by your healthcare team for signs of the disease progressing to multiple myeloma or a related condition. This is called watchful waiting. Other treatment is given when MGUS starts to progress to cancer. […] During watchful waiting, you may have the following tests: health history and physical exam, complete blood count (CBC), serum protein electrophoresis (SPEP), urinalysis to measure calcium and creatinine in the urine, serum free light chain test. […] If you have low-risk MGUS, a follow-up visit is scheduled 6 months after diagnosis. If the disease is stable, follow-ups will be scheduled every 2 to 3 years until you start developing symptoms or signs that the MGUS is progressing.

• #7 Monoclonal gammopathy of undetermined significance | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/multiple-myeloma/what-is-multiple-myeloma/monoclonal-gammopathy-of-undetermined-significance

  If you have high-risk MGUS, a follow-up visit is scheduled 6 months after a diagnosis, then once every year until you start developing symptoms or signs that the MGUS is progressing. […] Don’t wait until your next scheduled appointment if you develop any signs or symptoms of multiple myeloma. Report any new symptoms or symptoms that don’t go away.

• #8 Risk of MGUS Progression to Myeloma Can Change – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2019/mgus-multiple-myeloma-progression-risk

  A new study suggests that a persons risk of progressing from a benign condition called monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma, a type of blood cancer, can change over time. […] Currently, only people who have a high- or intermediate-risk MGUS are recommended to receive annual follow-up tests to check for signs of progression. However, the study investigators said that their findings support annual blood tests for all individuals with MGUS, regardless of their initial risk assessment. […] There is no treatment to prevent MGUS from progressing into multiple myeloma. Follow-up care for those with MGUS depends on a persons initial risk assessment. […] The findings that low- and intermediate-risk MGUS could convert to high-risk MGUS within a few years, the study authors wrote, supports annual blood testing for all individuals diagnosed with MGUS or light-chain MGUS, as well as yearly assessment of a patients clinical risk status.

• #9 MGUS (Monoclonal Gammopathy Of Unknown Significance) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/worried-about-cancer/pre-cancerous-and-genetic-conditions/mgus

  MGUS does not usually need treatment as it rarely causes any symptoms. In most people, MGUS remains stable and never causes any problems. […] There is a small risk of MGUS developing into a cancer, such as myeloma or lymphoma. If this happens, it is usually a slow-growing lymphoma. This can cause certain symptoms. Always contact your doctor if you have any of these symptoms: new or constant bone pain (such as in the back, ribs, hip or pelvis), different infections, one after another, that need antibiotics to treat them, feeling short of breath, extreme tiredness (fatigue), unexplained weight loss, night sweats, new lumps or swellings. […] Your doctor may also recommend you have regular blood tests. These will be like the ones you had at diagnosis. […] In the first year, you may have blood tests every few months. If your blood tests are normal after this time and you have no new symptoms, you have blood tests less often.

• #10 Monoclonal Gammopathy of Undetermined Significance (MGUS) | Cleveland Clinic

  https://my.clevelandclinic.org/podcasts/cancer-advances/monoclonal-gammopathy-of-undetermined-significance-mgus

  Sandra Mazzoni, DO, a hematologist at Cleveland Clinic Taussig Cancer Institute joins the Cancer Advances podcast to talk about monoclonal gammopathy of undetermined significance, known as MGUS. […] So, the most common one is probably monoclonal gammopathy of renal significance. […] So, these patients will go through a thorough myeloma-style workup, including what we call advanced imaging. […] But the question about treatment, so a lot of this treatment is myeloma research focused. […] There are guidelines within the International Myeloma Society, and we often treat this as active myeloma. […] So, it’s really monoclonal gammopathy of undetermined significance, but once you have some element of an organ dysfunction, even if it’s not full-blown criteria for myeloma, we can still effectively treat patients.

• #11 Monoclonal Gammopathies of Undetermined Significance (MGUS) Medication

  https://emedicine.medscape.com/article/204297-medication

  No treatment is recommended for patients with uncomplicated monoclonal gammopathy of undetermined significance (MGUS). […] Treatment recommendations for patients with monoclonal gammopathy of clinical significance (ie, those with signs and symptoms referable to nerves, kidneys, and/or skin) are largely anecdotal. […] However, in patients with monoclonal gammopathy of renal significance (MGRS), management follows the treatment algorithm for multiple myeloma in cases of nonIgM and free light chainassociated MGRS, and follows that for Waldenstrm macroglobulinemia in cases of IgMassociated MGRS. […] For several of the neurologic and dermatologic conditions, intravenous immunoglobulin, rituximab, and plasma celldirected therapy have shown benefit. […] For example, a prospective open-label trial by Niermeijer et al in 17 patients with IgM MGUS polyneuropathy found that treatment with rituximab was associated with improvement in three impairment measures, and no serious adverse events.

• #12 Monoclonal gammopathy of undetermined significance (MGUS) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/monoclonal-gammopathy-of-undetermined-significance-mgus?content_id=CON-20166978

  MGUS doesn’t require treatment. But your health care provider is likely to have you get regular checkups to watch the condition. Checkups likely will start six months after your diagnosis. […] For those at high risk of MGUS leading to a more serious condition, more-frequent checkups can watch the disease. That way, treatment can start as soon as possible if it’s needed. […] Medicine for the bone-thinning disease known as osteoporosis increase bone mass. Examples include alendronate (Fosamax), risedronate (Actonel, Atelvia), ibandronate and zoledronic acid (Reclast, Zometa).

• #13 Monoclonal Gammopathy of Undetermined Significance (MGUS) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/plasma-cell-disorders/monoclonal-gammopathy-of-undetermined-significance-mgus

  MGUS usually is asymptomatic, but peripheral neuropathy can occur, and patients are at higher risk of enhanced bone loss and fractures. […] No antineoplastic treatment is recommended. However, patients with MGUS and associated bone loss (osteopenia or osteoporosis) may benefit from treatment with intravenous bisphosphonates but less frequently than the monthly treatments usually required to treat patients with multiple myeloma. […] Every 6 to 12 months, patients should undergo clinical examination and serum and urine protein electrophoresis to evaluate for disease progression.

• #14 Monoclonal Gammopathy of Undetermined Significance (MGUS)

  https://www.healthline.com/health/how-serious-is-mgus

  Theres no way to treat MGUS. It doesnt go away on its own, but it doesnt usually cause symptoms or develop into a serious condition. […] A doctor will recommend regular checkups and blood tests to keep an eye on your health. Usually, these checkups start 6 months after first diagnosing MGUS. […] Because MGUS can lead to conditions that deteriorate bone mass, a doctor may recommend that you take medication to increase your bone density if you have osteoporosis. Some of these medications include: alendronate (Binosto, Fosamax), risedronate (Actonel, Atelvia), ibandronate (Boniva), zoledronic acid (Reclast, Zometa).

• #15 Treatment of Patients with Monoclonal Gammopathy of Clinical Significance

  https://www.mdpi.com/2072-6694/13/20/5131

  Treatment summary recommendation of neurologic-related disease. Single-agent rituximab is the first option for patients with anti-MAG IgM peripheral neuropathy or anti-ganglioside antibodies, with ibrutinib being the most promising option in refractory patients. For IgM MGUS peripheral neuropathy without autoantibodies, immunosuppressive treatment may be the first option, while PE, rituximab, immunochemotherapy, or ibrutinib can be considered for unresponsive patients. […] MGCS is a newly emergent concept. Screening for an underlying malignancy, such as MM, WM, AL amyloidosis, or other lymphoproliferative disorders, is mandatory. Treatment is based on the presence of symptoms, particularly if they cause disability. When the diagnosis is established, a risk to benefit approach is the first step. Many of these MGCS are diagnosed in the setting of an already established disease. The next approach should be to assess the M-protein isotype involved, as non-IgM-related diseases are treated with anti-myeloma agents, while anti-CD20-based regimens are the preferred option for IgM-related diseases. Although not enough data are available, this review summarizes the treatment possibilities for MGCS and gives insight into new potential therapeutic targets. Both hematological and clinical response should be the main goals after treatment. High-dose melphalan followed by ASCT has to be considered for fit patients. In our experience, this approach is safe and can result in long-term remissions. Finally, we consider that high-throughput technologies analyzing both the plasma/B-cell clones and the bone marrow immune microenvironment might answer unsolved questions in MGCS and find new potential targets.

• #16 Treatment of Patients with Monoclonal Gammopathy of Clinical Significance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8533809/

  Treatment depends on the severity of symptoms and the underlying cause. Besides WM-associated cryoglobulinemia that has international consensus, there is no current standard recommendations for treatment. The first step is to explain and educate patients that cold exposure can exacerbate vasomotor symptoms. Wearing warm clothes to protect hands and feet when exposed to cold temperature is necessary. However, patients with overt skin lesions are usually seen. In this scenario, the next step should be focused on the underlying disease. Single-agent prednisone may control the disease in patients with low tumor burden (IgG or IgM MGUS). In the case of WM, the initial approach should be the current recommended therapy for this disease. […] Treatment summary recommendation of skin related MGCS. Type 1 cryoglobulinemia responds to corticosteroids, cyclophosphamide, and PE in the absence of overt malignancy. If the underlying M-protein is IgM, rituximab and/or alkylating agents may be considered. Severe cases or the presence of underlying MM may respond to anti-myeloma agents. Schnitzler syndrome treatment is based on anti-IL1 agents (anakinra), with effective remission of symptoms. Anti-myeloma agents should be used only in refractory disease. Non-severe scleromyxedema treatment with IVIG can be considered. For refractory or severe manifestations, addition with anti-myeloma agents can achieve hematological and clinical response.

• #17 Treatment of Patients with Monoclonal Gammopathy of Clinical Significance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8533809/

  Treatment summary recommendation of M-protein related bleeding disorders. Whether the bleeding disorder is caused by an acquired von Willebrand syndrome or a platelet aggregation disorder, supportive treatment with coagulation factors is mandatory in case of life-threatening bleeding or given as prophylaxis before procedures. Definitive treatment is against the underlying monoclonal gammopathy, as it can reverse the hemostatic abnormalities. A benefit-to-risk approach should be made in patients with MGUS. However, as the disease consists of bleeding and is potentially life-threatening, anti-myeloma therapy is recommended. […] Treatment summary recommendation of ocular-related disease. Patients without significant symptoms should be followed with a watch and wait strategy. However, when symptoms worsen with a risk of visual loss, the need of treatment is mandatory. As in other types of LCDD, treatment with anti-myeloma agents can achieve clinical and hematologic responses with long-lasting remissions.

• #18 MGUS – Myeloma UK

  https://www.myeloma.org.uk/understanding-myeloma/related-conditions/mgus/

  MGUS is actively monitored but not treated. This is because many patients with MGUS remain well and never develop any problems related to it. However, a very small number of people with MGUS go on to develop another, more serious condition. For example, over a 10-year period, 10% of people (1 in 10 people) with MGUS will develop myeloma (a blood cancer). For this reason, it is important to have regular blood tests to check for any change in your condition. Regular checks will make sure that if you need treatment, you can have it as soon as it is necessary. […] There is not yet anything anyone can do to prevent MGUS from progressing to another condition. […] Living with a condition for which there is no treatment or cure and that can, in a small number of cases, develop into something more serious can be difficult. Get the support you need by getting in touch.

• #19 Changing paradigms in diagnosis and treatment of monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) | Leukemia

  https://www.nature.com/articles/s41375-020-01051-x

  Multiple myeloma (MM) is a highly heterogenous disease that exists along a continuous disease spectrum starting with premalignant conditions monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) that inevitably precede MM. […] Indeed, the clinical introduction of highly effective and well-tolerated drugs begs the question: would earlier therapeutic intervention with novel therapies in MGUS and SMM patients alter natural history, providing a potential curative option? […] Finally, we provide an overview of the current recommendations for the management of MGUS and SMM and discuss the open controversies in the field in light of promising results from early intervention clinical trials. […] Landgren O, Kyle RA, Rajkumar SV. From myeloma precursor disease to multiple myeloma: new diagnostic concepts and opportunities for early intervention. Clin Cancer Res. 2011;17:124352.

• #20 Management of Monoclonal Gammopathy of Undetermined Significance (MGUS) and Smoldering Multiple Myeloma (SMM)

  https://www.cancernetwork.com/view/management-monoclonal-gammopathy-undetermined-significance-mgus-and-smoldering-multiple-myeloma-smm

  Observation is the standard of care. However, clinical trials are ongoing to determine whether early therapy with newer agents can prolong the time to progression-and most importantly, prolong survival. […] Treatment is not indicated unless it is part of a clinical trial. […] In the United States, the Eastern Cooperative Oncology Group has recently activated a trial testing the role of lenalidomide (Revlimid) in SMM; this agent has shown promise in this setting in recent studies.

• #21 Changing paradigms in diagnosis and treatment of monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) | Leukemia

  https://www.nature.com/articles/s41375-020-01051-x

  Mateos MV, Hernndez MT, Giraldo P, de la Rubia J, de Arriba F, Lpez Corral L, et al. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N. Engl J Med. 2013;369:43847. […] Lonial S, Jacobus S, Fonseca R, Weiss M, Kumar S, Orlowski RZ, et al. Randomized Trial of Lenalidomide Versus Observation in Smoldering Multiple Myeloma. J Clin Oncol. 2020;38:112637. […] Korde N, Roschewski M, Zingone A, Kwok M, Manasanch EE, Bhutani M, et al. Treatment with carfilzomib-lenalidomide-dexamethasone with lenalidomide extension in patients with smoldering or newly diagnosed multiple myeloma. JAMA Oncol. 2015;1:74654. […] Perrot A, Lauwers-Cances V, Corre J, Robillard N, Hulin C, Chretien ML, et al. Minimal residual disease negativity using deep sequencing is a major prognostic factor in multiple myeloma. Blood. 2018;132:245664.

• #22 Changing paradigms in diagnosis and treatment of monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) | Leukemia

  https://www.nature.com/articles/s41375-020-01051-x

  Landgren CO, Chari A, Cohen YC, Spencer A, Voorhees P, Estell JA, et al. Daratumumab monotherapy for patients with intermediate-risk or high-risk smoldering multiple myeloma: a randomized, open-label, multicenter, phase 2 study (CENTAURUS). Leukemia. 2020;34:184052. […] Mateos M-V, Martinez-Lopez J, Rodriguez Otero P, Gonzalez-Calle V, Gonzalez MS, Oriol A, et al. Curative Strategy (GEM-CESAR) for High-Risk Smoldering Myeloma (SMM): Carfilzomib, Lenalidomide and Dexamethasone (KRd) As Induction Followed By HDT-ASCT, Consolidation with Krd and Maintenance with Rd. Blood 2019;134(Supplement_1):781.

• #23 Treatment of Patients with Monoclonal Gammopathy of Clinical Significance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8533809/

  Treatment is based on the presence of symptoms, particularly if they cause disability. When the diagnosis is established, a risk to benefit approach is the first step. Many of these MGCS are diagnosed in the setting of an already established disease. The next approach should be to assess the M-protein isotype involved, as non-IgM-related diseases are treated with anti-myeloma agents, while anti-CD20-based regimens are the preferred option for IgM-related diseases. Although not enough data are available, this review summarizes the treatment possibilities for MGCS and gives insight into new potential therapeutic targets. Both hematological and clinical response should be the main goals after treatment. High-dose melphalan followed by ASCT has to be considered for fit patients. In our experience, this approach is safe and can result in long-term remissions.

• #24

  https://haematologica.org/article/view/7062

  Presenting features as well as the dynamics of the plasma cell clone during the first years of follow up are helpful in predicting risk of progression of MGUS to symptomatic disease. […] Therapy should be initiated only when symptomatic disease develops. […] Treatment of M-protein-related disorders is dependent on severity. […] Institution of supportive care alone may be sufficient in cases with only mild symptoms. […] However, in general, the most effective treatment of M-protein-related disorders is directed to the underlying clone. […] Rituximab monotherapy is recommended in cases of IgM-related disease, such as anti-MAG polyneuropathy. […] Addition of chemotherapy to rituximab can be considered in cases with severe symptoms and the need for rapid tumor reduction. […] In non-IgM MGUS-related disorders therapy should rely on antimyeloma agents.

• #25

  https://haematologica.org/article/view/7062

  In younger patients (65-70 years) high-dose melphalan with autoSCT to induce a long-term remission can be considered if the symptoms are severe, progressive and/or disabling, like in POEMS syndrome. […] A lenalidomide-based regimen is the first choice in patients with neuropathy, while bortezomib has the highest efficacy in M-protein-associated renal disorders, since it rapidly reduces tumor load and toxic M-proteins.

• #26 Monoclonal Gammopathy of Undetermined Significance – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507880/

  The intensity of follow-up in patients with MGUS is guided by risk stratification. Initial follow-up at six months is recommended, with subsequent visits scheduled according to the level of risk. If clinical trials of preventive strategies are available, patients at high risk for progression should be encouraged to participate. […] Monoclonal gammopathy of undetermined significance (MGUS) patients have no specific treatment, they should undergo detail clinical examination, serum, and urine protein electrophoresis regularly every six to twelve months to look for disease progression. Patients with osteopenia or osteoporosis may benefit from bisphosphonate therapy. […] Monoclonal gammopathy of undetermined significance (MGUS) is best managed by an interprofessional team that includes primary care providers, hematologists, medical oncologists, and nurses. There is no specific treatment for these patients, they only need long-term follow-up because of the potential to progress to myeloproliferative disorders and numerous other complications.

• #27 Precursor Conditions to Multiple Myeloma | Myeloma Center

  https://www.myelomacenter.org/patients/other-plasma-cell-disorders/precursor-conditions-multiple-myeloma

  Although MGUS is usually silent and does not cause overt symptoms, rarely, monoclonal proteins can damage vital organs. This is usually suspected in individuals who present with unexplained symptoms. The kidneys, peripheral nerves, and skin can be among the organs most often affected. When this is suspected, a further work up might be warranted including biopsies or referral to a specialist such as a dermatologist, neurologist, or nephrologist. Treatment is available in certain cases including IV immunoglobulin, rituximab, and plasma celldirected therapies. […] If someone is diagnosed with SMM, it is very important to receive routine follow-up care to monitor for progression to multiple myeloma and if necessary, begin a treatment plan early. An initial smoldering multiple myeloma diagnosis does not usually require immediate treatment.

• #28 MGUS | Harold C. Simmons Comprehensive Cancer Center | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/mgus/

  At UT Southwestern, we adopt a comprehensive and patient-centered approach to managing precursor conditions such as monoclonal gammopathy of undetermined significance (MGUS). […] Our dedicated Monoclonal Gammopathy Precursor team provides personalized monitoring and care to help with early detection and optimal outcomes. […] UT Southwesterns Monoclonal Gammopathy Precursor (MGP) team helps patients receive accurate diagnoses and personalized monitoring based on the latest medical guidelines. Our goal is to detect any changes early, provide peace of mind, and offer proactive care that aligns with each patient’s needs. […] Our team includes renowned specialists trained by prominent leaders in myeloma and monoclonal gammopathy research. This depth of expertise allows us to provide leading-edge treatment and management strategies.

• #29

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abr0714

  Most people with MGUS don’t need any treatment. But you may need regular physical exams, blood tests, and urine tests to make sure that MGUS isn’t progressing to a medical problem. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

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