Monoklonalna gammapatia o nieokreślonym znaczeniu (mgus)
Objawy

Monoklonalna gammapatia o nieokreślonym znaczeniu (MGUS) to stan przednowotworowy charakteryzujący się obecnością białka monoklonalnego (białka M) w surowicy poniżej 30 g/l (3 g/dl) oraz obecnością komórek plazmatycznych w szpiku kostnym <10%. MGUS nie wywołuje uszkodzeń narządów końcowych typowych dla szpiczaka mnogiego, takich jak hiperkalcemia, niewydolność nerek, niedokrwistość czy zmiany kostne. Występuje u 3-5% populacji powyżej 50. roku życia, z rosnącą częstością u osób starszych, częściej u mężczyzn i osób rasy czarnej. Roczne ryzyko progresji do nowotworów hematologicznych, w tym szpiczaka mnogiego, amyloidozy AL, makroglobulinemii Waldenströma i chłoniaków, wynosi około 1%, przy czym ryzyko to jest wyższe w przypadku IgM MGUS (2% rocznie w pierwszych 10 latach) niż non-IgM MGUS (0,51% rocznie). Czynniki ryzyka progresji obejmują stężenie białka M ≥ 1,5 g/dl, typ immunoglobuliny (non-IgG), nieprawidłowy stosunek wolnych łańcuchów lekkich (FLC), ≥ 5% komórek plazmatycznych w szpiku oraz immunoparezę.

  1. Monoklonalna gammapatia o nieokreślonym znaczeniu (MGUS) – definicja i charakterystyka
  2. Objawy MGUS
  3. Ryzyko progresji MGUS do chorób nowotworowych
    1. Czynniki ryzyka progresji
    2. Dynamika ryzyka progresji
  4. Inne powikłania związane z MGUS
  5. Monitorowanie MGUS i objawy progresji
    1. Objawy sugerujące progresję MGUS
    2. Badania diagnostyczne w monitorowaniu MGUS
  6. Postępowanie z MGUS
    1. Parametry wymagające szczególnej uwagi
  7. Jakość życia i aspekty psychologiczne
  8. Podsumowanie
    1. Kolejne rozdziały

Monoklonalna gammapatia o nieokreślonym znaczeniu (MGUS) – definicja i charakterystyka

Monoklonalna gammapatia o nieokreślonym znaczeniu (MGUS) to zaburzenie komórek plazmatycznych w szpiku kostnym, charakteryzujące się obecnością nieprawidłowego białka monoklonalnego (białka M) we krwi. MGUS jest stanem przednowotworowym, w którym nieprawidłowe komórki plazmatyczne wytwarzają atypowe przeciwciała, jednak ich liczba w szpiku kostnym nie przekracza 10%, a stężenie białka monoklonalnego w surowicy jest niższe niż 30 g/l lub 3 g/dl12. Stan ten nie powoduje uszkodzenia narządów końcowych charakterystycznych dla szpiczaka mnogiego (hiperkalcemia, niewydolność nerek, niedokrwistość lub zmiany kostne)3.

MGUS jest najczęstszym zaburzeniem komórek plazmatycznych, występującym u około 3-5% populacji powyżej 50. roku życia, przy czym częstość występowania wzrasta z wiekiem – do około 5% u osób powyżej 70. roku życia i nawet do 10% u osób powyżej 85 lat45. Częściej występuje u mężczyzn oraz u osób rasy czarnej67.

Objawy MGUS

MGUS zazwyczaj nie powoduje żadnych objawów i najczęściej jest wykrywane przypadkowo podczas badań krwi wykonywanych z innych powodów89. W większości przypadków pacjenci z MGUS nie doświadczają żadnych dolegliwości związanych z tym stanem i mogą prowadzić normalne życie bez świadomości jego istnienia10.

U niektórych pacjentów mogą jednak wystąpić pewne objawy lub powikłania, które mogą być związane z MGUS:

  • Neuropatia obwodowa – niektórzy pacjenci doświadczają zaburzeń neurologicznych objawiających się jako drętwienie, mrowienie, ból lub osłabienie w kończynach, szczególnie w rękach i stopach1112. Może to być wynikiem uszkodzenia nerwów spowodowanego paraproteinami we krwi13.
  • Zaburzenia równowagi – u niektórych osób MGUS może powodować problemy z utrzymaniem równowagi14.
  • Zmiany skórne – u części pacjentów mogą wystąpić wysypki skórne15.

Ryzyko progresji MGUS do chorób nowotworowych

Głównym problemem związanym z MGUS jest ryzyko progresji do poważniejszych chorób, przede wszystkim nowotworów hematologicznych. Roczne ryzyko progresji MGUS do chorób nowotworowych wynosi około 1%1617. Oznacza to, że co roku około 1 na 100 osób z MGUS rozwinie jakiś rodzaj nowotworu układu krwiotwórczego.

Choroby, do których może dojść w wyniku progresji MGUS, obejmują1819:

  • Szpiczak mnogi (multiple myeloma) – najczęstszy nowotwór, który rozwija się z MGUS
  • Amyloidoza łańcuchów lekkich (AL amyloidosis)
  • Makroglobulinemia Waldenströma (Waldenstrom macroglobulinemia)
  • Chłoniak (lymphoma)

Ryzyko progresji różni się w zależności od typu MGUS. IgM MGUS ma wyższe ryzyko progresji niż non-IgM MGUS i jest zwykle związane z rozwojem chłoniaka limfoplazmocytowego/makroglobulinemii Waldenströma. Ryzyko progresji u pacjentów z IgM MGUS wynosi 2% rocznie w pierwszych 10 latach po diagnozie i 1% rocznie później. Z kolei non-IgM MGUS jest związane z ryzykiem progresji do szpiczaka mnogiego na poziomie 0,51% rocznie20.

Długoterminowe ryzyko progresji MGUS do chorób nowotworowych można oszacować następująco21:

  • 10 lat po diagnozie: około 10%
  • 20 lat po diagnozie: około 18%
  • 30 lat po diagnozie: około 28%
  • 35 lat po diagnozie: około 36%

Czynniki ryzyka progresji

Zidentyfikowano kilka czynników ryzyka, które zwiększają prawdopodobieństwo progresji MGUS do chorób nowotworowych2223:

  • Wysokie stężenie białka M – stężenie białka monoklonalnego ≥ 1,5 g/dl
  • Typ immunoglobuliny – non-IgG MGUS (np. IgA, IgM, IgD)
  • Nieprawidłowy stosunek wolnych łańcuchów lekkich w surowicy (FLC ratio)
  • Wysoki odsetek komórek plazmatycznych w szpiku kostnym (≥ 5%)
  • Obniżone stężenie niezaangażowanych immunoglobulin (immunopareza)

Ryzyko progresji do nowotworów układu limfoproliferacyjnego w ciągu 20 lat wynosi 5% przy jednym czynniku ryzyka, 21% przy dwóch czynnikach ryzyka i 58% przy trzech czynnikach ryzyka24.

Dynamika ryzyka progresji

Nowe badania sugerują, że ryzyko progresji MGUS do szpiczaka mnogiego może zmieniać się w czasie. Zaobserwowano, że osoby z pierwotnie niskim lub pośrednim ryzykiem mogą w ciągu kilku lat przejść do grupy wysokiego ryzyka, co uzasadnia regularne badania kontrolne u wszystkich pacjentów z MGUS, niezależnie od początkowej oceny ryzyka25.

Ponadto, badania wskazują, że osoby z MGUS, które wykazują progresję do szpiczaka mnogiego, mogą mieć gorsze rokowanie, niezależnie od tego, czy MGUS było monitorowane26. Sugeruje to, że chociaż pacjenci z MGUS o niskim ryzyku rzadziej rozwijają szpiczaka mnogiego, istnieje podgrupa tych pacjentów, którzy w przypadku progresji należą do grupy bardziej agresywnych nowotworów.

Inne powikłania związane z MGUS

Oprócz ryzyka progresji do chorób nowotworowych, MGUS może być związane z innymi powikłaniami zdrowotnymi2728:

  • Osteoporoza i zwiększone ryzyko złamań – pacjenci z MGUS mogą mieć obniżoną gęstość mineralną kości, co zwiększa ryzyko złamań, szczególnie w obrębie lub w pobliżu szkieletu osiowego2930.
  • Neuropatia obwodowa – jak wspomniano wcześniej, u około 5% pacjentów z MGUS występuje neuropatia obwodowa31.
  • Zwiększone ryzyko infekcji – pacjenci z MGUS mają około 2-krotnie zwiększone ryzyko rozwoju infekcji bakteryjnych i wirusowych w porównaniu z osobami bez MGUS32.
  • Problemy z nerkami – w niektórych przypadkach białka monoklonalne mogą odkładać się w nerkach, powodując ich uszkodzenie33.
  • Zwiększone ryzyko zakrzepicy – pacjenci z MGUS mają około 23-krotnie zwiększone ryzyko rozwoju zakrzepicy żył głębokich lub zatorowości płucnej. Zwiększone ryzyko zakrzepicy żylnej i tętniczej obserwowano tylko w IgG i IgA MGUS, ale nie w IgM MGUS34.
  • Choroby układu sercowo-naczyniowego – pacjenci z non-IgM MGUS mają zwiększone ryzyko chorób tętnic w porównaniu z osobami bez MGUS35.
  • Niedobór odporności wtórny – MGUS jest uznaną przyczyną wtórnego niedoboru przeciwciał36.

Monitorowanie MGUS i objawy progresji

Pacjenci z MGUS wymagają regularnych badań kontrolnych w celu monitorowania stanu choroby i wczesnego wykrycia ewentualnej progresji37. Częstotliwość badań kontrolnych zależy od indywidualnego ryzyka progresji:

  • MGUS niskiego ryzyka: wizyta kontrolna 6 miesięcy po diagnozie, a następnie, jeśli stan jest stabilny, co 2-3 lata lub w przypadku wystąpienia objawów sugerujących progresję38.
  • MGUS wysokiego ryzyka: wizyta kontrolna 6 miesięcy po diagnozie, a następnie raz w roku do końca życia lub do momentu wystąpienia objawów progresji39.

Najnowsze badania sugerują jednak, że wszystkie osoby z MGUS, niezależnie od początkowej oceny ryzyka, powinny być poddawane corocznym badaniom krwi i ocenie klinicznej, ponieważ ryzyko progresji może zmieniać się w czasie40.

Objawy sugerujące progresję MGUS

Pacjenci z MGUS powinni zgłaszać lekarzowi wszelkie nowe lub nasilające się objawy, które mogą wskazywać na progresję do poważniejszej choroby. Do objawów, które powinny budzić niepokój, należą414243:

  • Ból kostny – szczególnie w plecach, żebrach, biodrach lub miednicy
  • Zmęczenie lub osłabienie
  • Niezamierzona utrata masy ciała
  • Gorączka lub poty nocne
  • Bóle głowy, zawroty głowy, ból nerwów lub zmiany w widzeniu lub słuchu
  • Krwawienia
  • Niedokrwistość lub inne nieprawidłowości we krwi
  • Powiększone węzły chłonne, wątroba lub śledziona
  • Nawracające infekcje wymagające antybiotyków
  • Duszność

W przypadku wystąpienia któregokolwiek z tych objawów, pacjent powinien skontaktować się z lekarzem w ciągu dwóch tygodni, nie czekając na kolejną planową wizytę kontrolną44.

Badania diagnostyczne w monitorowaniu MGUS

Monitorowanie MGUS obejmuje regularne badania kliniczne oraz badania laboratoryjne45:

  • Badanie kliniczne – ocena objawów i ogólnego stanu zdrowia
  • Morfologia krwi obwodowej (CBC)
  • Panel metaboliczny
  • Elektroforeza białek surowicy (SPEP) – monitorowanie stężenia białka M
  • Badanie wolnych łańcuchów lekkich w surowicy (FLC)
  • Ilościowa elektroforeza immunoglobulin surowicy
  • Elektroforeza białek moczu (UPEP) – w wybranych przypadkach

W przypadku wystąpienia objawów sugerujących progresję, mogą być zalecane dodatkowe badania, takie jak biopsja szpiku kostnego, badania obrazowe (RTG, MRI, PET-CT) lub inne badania specjalistyczne46.

Postępowanie z MGUS

MGUS samo w sobie nie wymaga leczenia4748. Obecnie nie ma żadnych specyficznych terapii, które mogłyby zapobiec progresji MGUS do chorób nowotworowych49. Głównym elementem postępowania jest regularne monitorowanie stanu pacjenta w celu wczesnego wykrycia progresji.

Chociaż MGUS samo w sobie nie jest leczone, mogą być leczone powikłania lub objawy związane z tym stanem50. Na przykład, w przypadku ciężkiej neuropatii obwodowej lekarz może przepisać leki łagodzące objawy.

Warto zauważyć, że pojawiają się badania sugerujące potencjalną rolę metforminy w zmniejszaniu ryzyka progresji MGUS do szpiczaka mnogiego u pacjentów z cukrzycą typu 2, jednak dane te są nadal bardzo ograniczone i wymagają dalszych badań51.

Parametry wymagające szczególnej uwagi

Podczas monitorowania MGUS należy zwrócić szczególną uwagę na następujące parametry, które mogą sugerować progresję do choroby nowotworowej52:

  • Wzrost stężenia białka M o co najmniej 50% (z bezwzględnym wzrostem o 0,5 g/dl)
  • Stężenie białka M ≥ 3 g/dl
  • Stosunek wolnych łańcuchów lekkich w surowicy > 100
  • Niewyjaśniona niedokrwistość
  • Podwyższony poziom kreatyniny
  • Ból kostny
  • Złamania
  • Hiperkalcemia

Jakość życia i aspekty psychologiczne

Diagnoza MGUS, choć jest to stan niezłośliwy, może powodować niepokój u pacjentów ze względu na ryzyko progresji do chorób nowotworowych53. Pacjenci mogą doświadczać obaw związanych z niepewnością co do przyszłości, zwłaszcza że stan ten wymaga regularnego monitorowania przez całe życie.

Ważne jest, aby pamiętać, że większość osób z MGUS nigdy nie rozwinie choroby nowotworowej i może prowadzić normalne życie54. Edukacja pacjenta na temat charakteru MGUS, rzeczywistego ryzyka progresji oraz znaczenia regularnych badań kontrolnych może pomóc w zmniejszeniu lęku i poprawie jakości życia.

Wsparcie psychologiczne i grupy wsparcia dla pacjentów z MGUS i ich rodzin mogą być pomocne w radzeniu sobie z emocjonalnymi aspektami życia z tą diagnozą55.

Podsumowanie

Monoklonalna gammapatia o nieokreślonym znaczeniu (MGUS) to łagodny stan przednowotworowy charakteryzujący się obecnością nieprawidłowego białka monoklonalnego we krwi. Chociaż MGUS samo w sobie zwykle nie powoduje objawów, niesie ze sobą ryzyko progresji do poważniejszych chorób, w tym szpiczaka mnogiego i innych nowotworów hematologicznych.

Roczne ryzyko progresji MGUS do chorób nowotworowych wynosi około 1% i zależy od kilku czynników, w tym stężenia białka M, typu immunoglobuliny oraz stosunku wolnych łańcuchów lekkich w surowicy. Regularne monitorowanie stanu pacjenta jest kluczowe dla wczesnego wykrycia progresji i podjęcia odpowiedniego leczenia.

Oprócz ryzyka progresji do nowotworów, MGUS może być związane z innymi powikłaniami, takimi jak osteoporoza, neuropatia obwodowa, zwiększone ryzyko infekcji, problemy z nerkami i choroby układu sercowo-naczyniowego.

Mimo że nie ma obecnie terapii zapobiegającej progresji MGUS, większość pacjentów z tym stanem nigdy nie rozwinie choroby nowotworowej i może prowadzić normalne życie z odpowiednim monitorowaniem medycznym.

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  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Monoclonal Gammopathy of Undetermined Significance – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK507880/
    Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic preneoplastic plasma cell disorder that is characterized by serum M-protein less than 30 g/L, bone marrow clonal plasma cells less than 10 percent, absence of plasma cell myeloma-related end-organ damage (hypercalcemia, renal insufficiency, anemia, or bone lesions) and absence of B-cell lymphoma or other diseases known to produce an M-protein. MGUS is generally considered a preneoplastic disorder that does not always progress to overt malignancy. […] The majority of non-IgM MGUS patients are asymptomatic. […] Non-IgM MGUS is usually diagnosed as an incidental finding on protein electrophoresis performed as part of an evaluation for disorders or disease presentation of peripheral neuropathy, vasculitis, hemolytic anemia, skin rashes, hypercalcemia, elevated erythrocyte sedimentation rate. Non-IgM MGUS is generally not considered a neoplastic process, with an annual risk of progression of 1%. Non-IgM MGUS may progress to PCM, solitary plasmacytoma, or amyloidosis.
  • #2 Monoclonal Gammopathies of Undetermined Significance (MGUS): Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/204297-overview
    Monoclonal gammopathy of undetermined significance (MGUS) is the most common of a spectrum of diseases called plasma cell dyscrasias. The term MGUS denotes the presence of a monoclonal immunoglobulin (Ig), also called an M-protein, in the serum or urine in persons without evidence of multiple myeloma (MM), Waldenstrm macroglobulinemia (WM), amyloidosis (AL) or other lymphoproliferative disorders. […] All pose a risk, albeit varying, of progression to a malignant disorder. Typically, IgG and IgA MGUS progress to MM, IgM MGUS progresses to WM or other lymphoproliferative disorders, and light-chain MGUS is the precursor of light-chain MM. […] The risk of progression to MM or other lymphoproliferative disorder is present at a constant rate throughout the remainder of a patient’s life. This observation suggests that the second event responsible for progression is a random event and not cumulative.
  • #3 Monoclonal Gammopathy of Undetermined Significance – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK507880/
    Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic preneoplastic plasma cell disorder that is characterized by serum M-protein less than 30 g/L, bone marrow clonal plasma cells less than 10 percent, absence of plasma cell myeloma-related end-organ damage (hypercalcemia, renal insufficiency, anemia, or bone lesions) and absence of B-cell lymphoma or other diseases known to produce an M-protein. MGUS is generally considered a preneoplastic disorder that does not always progress to overt malignancy. […] The majority of non-IgM MGUS patients are asymptomatic. […] Non-IgM MGUS is usually diagnosed as an incidental finding on protein electrophoresis performed as part of an evaluation for disorders or disease presentation of peripheral neuropathy, vasculitis, hemolytic anemia, skin rashes, hypercalcemia, elevated erythrocyte sedimentation rate. Non-IgM MGUS is generally not considered a neoplastic process, with an annual risk of progression of 1%. Non-IgM MGUS may progress to PCM, solitary plasmacytoma, or amyloidosis.
  • #4 MGUS – Myeloma UK
    https://www.myeloma.org.uk/understanding-myeloma/related-conditions/mgus/
    Monoclonal gammopathy of undetermined significance, or ‘MGUS’, is a condition related to myeloma but it is not a cancer. Most people with MGUS will notice no effect on their general health. […] MGUS is a common condition that affects about 1 in 30 people over 50. This increases with age, rising to 1 in 20 people over 70 and up to nearly 1 in 10 people aged over 85. Most people will never know that they have the condition because it does not usually cause any symptoms. […] MGUS does not cause any symptoms and is usually diagnosed incidentally when tests are performed to investigate other problems. It does not require any treatment. […] While most MGUS patients have a stable condition that has no effect on their general health, a small proportion of patients will go on to develop a cancer called myeloma. MGUS can also progress to other conditions such as Waldenström’s macroglobulinaemia, AL amyloidosis or lymphoma.
  • #5 Monoclonal gammopathy of undetermined significance – Knowledge and References – Taylor & Francis
    https://taylorandfrancis.com/knowledge/Medicine_and_healthcare/Hematology/Monoclonal_gammopathy_of_undetermined_significance/
    MGUS is asymptomatic and present in 3% of the general population over the age of 50 years, with potential to progress at a rate of 1%-2% per year. SMM is also asymptomatic and carries a higher risk of progression at 10% a year for the first 5 years, 3% per year for the next 5 years, and 1% per year thereafter. […] Approximately 3% to 5% of individuals older than 50 have a monoclonal gammopathy of undetermined significance (MGUS) in absence of clinical evidence of myeloma. Some may progress and deposit monoclonal immunoglobulins in the kidney causing significant injury to glomeruli, renal tubules and/or renal vessels, so-called monoclonal gammopathy of renal significance. […] Monoclonal gammopathy of undetermined significance (MGUS) is more prevalent with advanced age, occurring in roughly 5% of all individuals 65 and older.
  • #6 Monoclonal Gammopathy of Undetermined Significance
    https://mobile.fpnotebook.com/HemeOnc/Marrow/MnclnlGmpthyOfUndtrmndSgnfcnc.htm
    Monoclonal Gammopathy of Undetermined Significance, MGUS […] Present in 2-3% of patients over age 50 years (increases to 5% in age over 70 years old) […] More common in men […] More common in black patients than white patients […] Risk of Multiple Myeloma is 58% in 20 years if all 3 factors present […] Progresses to Multiple Myeloma in 1% of cases per year.
  • #7 Monoclonal Gammopathy of Undetermined Significance (MGUS) ​
    https://watch.giblib.com/video/10267
    The other key factors are race. Clearly in the United States, we’ve noted that people of African descent, African-Americans or poor black persons are twice as likely to have MGUS than their Caucasian counterparts. […] There are various types of MGUS and some carry a more ominous prognosis than others. […] The intact monoclonal immunoglobulin is an IgG type and the difference between these two is the non-IgG types are more likely to progress to multiple myeloma if they were to do so in the future.
  • #8 Monoclonal gammopathy of undetermined significance (MGUS) – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/mgus/symptoms-causes/syc-20352362
    Monoclonal gammopathy of undetermined significance (MGUS) is a condition in which an atypical protein is found in the blood. […] MGUS usually causes no problems. But sometimes it can lead to more-serious diseases. These include some forms of blood cancer. […] People with monoclonal gammopathy often don’t have symptoms. Some people have a rash or nerve problems, such as numbness or tingling. A blood test for another condition might find MGUS by chance. […] Each year, about 1% of people with MGUS get certain types of blood cancers or other serious diseases, such as: Multiple myeloma, Light chain amyloidosis, Waldenstrom macroglobulinemia, Lymphoma. […] Other issues linked to MGUS include broken bones, blood clots, kidney problems, and damage to nerves outside of the brain and spinal cord, also known as peripheral neuropathy.
  • #9 Monoclonal gammopathy of undetermined significance (MGUS) – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/mgus/diagnosis-treatment/drc-20352367
    Because MGUS usually causes no symptoms, people who have it usually find out by chance during blood tests for other reasons. […] Symptoms to watch for include: Bone pain. Tiredness or weakness. Weight loss without trying. Fever or night sweats. Headache, dizziness, nerve pain, or changes in vision or hearing. Bleeding. Anemia or other blood irregularities. Swollen lymph nodes, liver or spleen. […] 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.
  • #10 Ask the Nurse: monoclonal gammopathy of undetermined significance (MGUS) – Myeloma UK
    https://www.myeloma.org.uk/library/ask-the-nurse-mgus/
    For most patients, a diagnosis of monoclonal gammopathy of undetermined significance (MGUS) does not affect their daily life. However, it can be concerning to receive a diagnosis for which there is no treatment, that requires regular monitoring, and has a very small possibility of developing into another condition. […] About four in five people with MGUS will never know that they have the condition because it usually does not progress or cause any symptoms. […] Some MGUS patients have mild symptoms such are tingling and numbness in the hands and feet, but they typically don’t need any treatments. […] About 1 in 100 people with MGUS (1%) each year develop a related cancer. For most people, MGUS will never progress into a more serious condition and will not require any treatment. […] The healthcare professional monitoring you will also ask about your general health and if anything has changed. This is because new or worsening symptoms could be a sign that MGUS is progressing to a more serious condition.
  • #11 Monoclonal Gammopathy of Undetermined Significance (MGUS)
    https://my.clevelandclinic.org/health/diseases/17744-monoclonal-gammopathy-of-undetermined-significance-mgus
    Monoclonal gammopathy of undetermined significance (MGUS) is a blood disorder that affects plasma cells in your bone marrow. Most of the time, M proteins dont cause issues and most people with MGUS dont have symptoms. Some people with this condition may develop a blood cancer or more serious blood disorder. […] This condition rarely causes symptoms. When people have symptoms, they may include: Tingling. Weakness. Numbness. […] In general, most people with monoclonal gammopathy of undetermined significance (MGUS) dont have symptoms. A small percentage of people develop certain blood cancers or blood disorders. If blood and urine tests show M proteins, youll need blood and urine tests every six to 12 months. That way, your healthcare providers can watch for signs your condition is becoming a serious illness.
  • #12 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 cause any symptoms. But a small number of people with MGUS have problems with their balance, or numbness or tingling in their hands and feet. This is called peripheral neuropathy. Symptoms may be because of damage to their nerves caused by paraproteins in the blood. […] 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. […] Some people may also have problems with the kidneys.
  • #13 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
    Monoclonal gammopathy of undetermined significance (MGUS) is a precancerous condition and the most common plasma cell disorder. Precancerous conditions are not yet cancer, but there is a chance these abnormal changes will eventually become cancer or a related condition. This can take months or years. […] MGUS often doesn’t have any signs or symptoms, but it may cause the following complications: Osteoporosis Some bones may become weak due to the high number of myeloma cells in the bone marrow and cause an increased risk of fractures and bone pain. Infections MGUS affects the immune system and can increase your risk for infections. Peripheral nerve damage (peripheral neuropathy) IgM MGUS may cause tingling or numbness in your hands and feet. […] In general, the risk of MGUS progressing to multiple myeloma is 1% each year and remains 1% each year you live with the disease. So, even 25 years after a diagnosis, the risk of MGUS progressing to multiple myeloma is still 1%.
  • #14 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 cause any symptoms. But a small number of people with MGUS have problems with their balance, or numbness or tingling in their hands and feet. This is called peripheral neuropathy. Symptoms may be because of damage to their nerves caused by paraproteins in the blood. […] 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. […] Some people may also have problems with the kidneys.
  • #15 Monoclonal gammopathy of undetermined significance – Wikipedia
    https://en.wikipedia.org/wiki/Monoclonal_gammopathy_of_undetermined_significance
    Monoclonal gammopathy of undetermined significance (MGUS) is a plasma cell dyscrasia in which plasma cells or other types of antibody-producing cells secrete a myeloma protein, i.e. an abnormal antibody, into the blood; this abnormal protein is usually found during standard laboratory blood or urine tests. MGUS resembles multiple myeloma and similar diseases, but the levels of antibodies are lower, the number of plasma cells (white blood cells that secrete antibodies) in the bone marrow is lower, and it rarely has symptoms or major problems. However, since MGUS can progress to multiple myeloma, with a rate ranging from 0.5% to 1.5% per year depending on the risk category, yearly monitoring is recommended. […] People with monoclonal gammopathy generally do not experience signs or symptoms. Some people may experience a rash or nerve problems, such as numbness or tingling. MGUS is usually detected by chance when the patient has a blood test for another condition or as part of standard screening.
  • #16 Monoclonal gammopathy of undetermined significance (MGUS) – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/mgus/symptoms-causes/syc-20352362
    Monoclonal gammopathy of undetermined significance (MGUS) is a condition in which an atypical protein is found in the blood. […] MGUS usually causes no problems. But sometimes it can lead to more-serious diseases. These include some forms of blood cancer. […] People with monoclonal gammopathy often don’t have symptoms. Some people have a rash or nerve problems, such as numbness or tingling. A blood test for another condition might find MGUS by chance. […] Each year, about 1% of people with MGUS get certain types of blood cancers or other serious diseases, such as: Multiple myeloma, Light chain amyloidosis, Waldenstrom macroglobulinemia, Lymphoma. […] Other issues linked to MGUS include broken bones, blood clots, kidney problems, and damage to nerves outside of the brain and spinal cord, also known as peripheral neuropathy.
  • #17 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. […] On average, about 1% of people with MGUS go on to develop multiple myeloma each year. […] But according to the new findings, published July 18 in JAMA Oncology, the levels of those blood markers and the risk of developing 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.
  • #18 Monoclonal gammopathy of undetermined significance (MGUS) – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/mgus/symptoms-causes/syc-20352362
    Monoclonal gammopathy of undetermined significance (MGUS) is a condition in which an atypical protein is found in the blood. […] MGUS usually causes no problems. But sometimes it can lead to more-serious diseases. These include some forms of blood cancer. […] People with monoclonal gammopathy often don’t have symptoms. Some people have a rash or nerve problems, such as numbness or tingling. A blood test for another condition might find MGUS by chance. […] Each year, about 1% of people with MGUS get certain types of blood cancers or other serious diseases, such as: Multiple myeloma, Light chain amyloidosis, Waldenstrom macroglobulinemia, Lymphoma. […] Other issues linked to MGUS include broken bones, blood clots, kidney problems, and damage to nerves outside of the brain and spinal cord, also known as peripheral neuropathy.
  • #19 Monoclonal gammopathy of undetermined significance (MGUS) – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube
    https://www.augustahealth.com/disease/monoclonal-gammopathy-of-undetermined-significance-mgus/
    Monoclonal gammopathy of undetermined significance (MGUS) is a condition in which an abnormal protein — known as monoclonal protein or M protein — is in your blood. […] MGUS usually causes no problems. But sometimes it can progress to more-serious diseases, including some forms of blood cancer. […] People with monoclonal gammopathy generally don’t experience signs or symptoms. Some people may experience a rash or nerve problems, such as numbness or tingling. MGUS is usually detected by chance when you have a blood test for another condition. […] Each year about 1% of people with MGUS go on to develop certain types of blood cancers or other serious diseases such as: Multiple myeloma, Light chain amyloidosis, Waldenstrom macroglobulinemia, Lymphoma. […] If you are at high risk of MGUS developing into a more serious condition, your doctor may recommend more frequent checkups so that any progression can be diagnosed and treatment started as soon as possible. […] Your doctor is likely to watch for signs and symptoms such as: Bone pain, Fatigue or weakness, Unintentional weight loss, Fever or night sweats, Headache, dizziness, nerve pain, or changes in vision or hearing, Bleeding, Anemia or other blood abnormalities, Swollen lymph nodes, liver or spleen.
  • #20 Monoclonal gammopathy of undetermined significance: evaluation, risk assessment, management, and beyond
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9720897/
    Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant state for a spectrum of lymphoplasmacytic malignancies. The risk of progression of MGUS to a symptomatic therapy requiring plasma cell dyscrasia is about 1% per year. […] MGUS is a clinically asymptomatic, premalignant, clonal plasma cell disorder and is an obligatory precursor for several LPMs, including MM, WM, and AL. […] The rate of progression of MGUS to LPM is 0.51% per year, but the exact risk depends on the concentration and type of the M protein, serum FLC ratio, bone marrow plasmacytosis, proportion of phenotypically clonal plasma cells, and presence of immunoparesis. […] IgM MGUS has a higher risk of progression than non-IgM and is typically associated with progression to lymphoplasmacytic lymphoma/WM. The risk of progression among patients with IgM MGUS is 2% per year in the first 10 years after diagnosis and 1% per year thereafter. In contrast, non-IgM MGUS is associated with a risk of progression to MM at a rate of 0.51% per year.
  • #21 Monoclonal Gammopathy of Undetermined Significance (MGUS)
    https://www.healthline.com/health/how-serious-is-mgus
    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. […] These symptoms include: anemia or other abnormalities of the blood, bleeding, changes in vision or hearing, fever or night sweats, headaches and dizziness, heart and kidney problems, pain, including nerve pain and bone pain, swollen liver, lymph nodes, or spleen, tiredness with or without weakness, unexplained weight loss. […] Most people with MGUS dont develop serious blood and bone marrow conditions. However, regular doctor visits and blood tests can help estimate your risk. […] Each year, MGUS has about a 1 percent chance of progressing into multiple myeloma. In a large study, researchers indicated the chances of MGUS becoming multiple myeloma over a 35-year period were: 10 years after diagnosis 10%, 20 years 18%, 30 years 28%, 35 years 36%.
  • #22 Monoclonal gammopathy of undetermined significance: evaluation, risk assessment, management, and beyond
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9720897/
    The three major risk factors for the progression of MGUS are an abnormal serum FLC ratio, non-IgG MGUS, and a high serum M protein level (1.5 g/dL). […] The risk of progression to LPM at 20 years when one, two, and three risk factors are present is 5%, 21%, and 58%, respectively. […] In addition to the aforementioned risk factors, a study found that the risk of progression was higher when there are 5% clonal plasma cells in the bone marrow and low concentrations of two uninvolved immunoglobulins. […] In the presence of these red flags in the correct clinical setting without an alternative explanation, one should promptly evaluate patients for progression to an LPM.
  • #23 Monoclonal Gammopathies of Undetermined Significance (MGUS): Practice Essentials, Pathophysiology, Epidemiology
    https://emedicine.medscape.com/article/204297-overview
    The annual risk of progression to multiple myeloma (MM), Waldenstrm macroglobulinemia (WM), amyloidosis (AL), or other lymphoproliferative disorders is approximately 1%. However, the mode and risk of progression vary between IgM MGUS and those with non-IgM MGUS. […] An abnormal serum free light-chain ratio (ratio of kappa to lambda free light chains) and a high serum monoclonal protein (M protein) level (1.5 g per deciliter) are risk factors for progression. […] In a study of 728 Swedish MGUS patients followed for up to 30 years, 84 patients developed a lymphoid disorder, representing a cumulative risk of 15.4%. The 30-year cumulative risk for myeloid malignancies was less than 2%. The 30-year cumulative risk for MM, which occurred in 53 patients, was 10.6%, with an approximately 0.5% annual risk. […] Although autoimmune disease is a well-described risk factor for the development of MGUS, a Swedish population-based study determined that patients with a history of autoimmune disease have a significantly lower risk of progression from MGUS to MM or other lymphoproliferative diseases.
  • #24 Monoclonal gammopathy of undetermined significance: evaluation, risk assessment, management, and beyond
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9720897/
    The three major risk factors for the progression of MGUS are an abnormal serum FLC ratio, non-IgG MGUS, and a high serum M protein level (1.5 g/dL). […] The risk of progression to LPM at 20 years when one, two, and three risk factors are present is 5%, 21%, and 58%, respectively. […] In addition to the aforementioned risk factors, a study found that the risk of progression was higher when there are 5% clonal plasma cells in the bone marrow and low concentrations of two uninvolved immunoglobulins. […] In the presence of these red flags in the correct clinical setting without an alternative explanation, one should promptly evaluate patients for progression to an LPM.
  • #25 Risk of MGUS Progression to Myeloma Can Change – NCI
    https://www.cancer.gov/news-events/cancer-currents-blog/2019/mgus-multiple-myeloma-progression-risk
    These recommendations assume that the risk of progression stays constant, Dr. Munshi and his colleagues wrote. […] However, if the risk of MGUS progression changed over time, someone whose disease initially appears to be low risk and opts for no follow-up could develop high-risk MGUS and need more intensive follow-up. […] 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. […] A potential benefit of annual blood testing is that it could lead to earlier detection of multiple myeloma, which could lessen or prevent severe myeloma-related complications like a bone fracture or kidney failure, Dr. Landgren said. […] A remaining issue is that there are limitations to using the standard blood markers to assess MGUS progression, the editorialists noted. […] Drs. Landgren and Hofmann are exploring other markers that may be more predictive of progression to myeloma.
  • #26 Progression patterns in monoclonal gammopathy of undetermined significance and multiple myeloma outcome: a cohort study in 42 patients | Experimental Hematology & Oncology | Full Text
    https://ehoonline.biomedcentral.com/articles/10.1186/s40164-022-00259-0
    Follow-up of low-risk monoclonal gammopathy of undetermined significance (MGUS) is debated as multiple myeloma (MM) progression risk is low. […] However, it is unknown whether progressing low-risk MGUS is associated with aggressive tumor behavior. Understanding these patterns is crucial for MGUS management. […] Our study, albeit limited by its small size, indicates that progression from low-risk MGUS is associated with worse MM outcome regardless of MGUS follow-up. […] We speculate that while low-risk MGUS patients are less likely to develop MM, there is a subset of these patients who will progress and, importantly, in case of progression belong to a group of more aggressive tumors.
  • #27 Monoclonal Gammopathy of Undetermined Significance (MGUS)—Not So Asymptomatic after All
    https://www.mdpi.com/2072-6694/12/6/1554
    Monoclonal Gammopathy of Undetermined Significance (MGUS) is considered to be a benign precursor condition that may progress to a lymphoproliferative disease or multiple myeloma. Most patients do not progress to an overt condition, but nevertheless, MGUS is associated with a shortened life expectancy and, in a minority of cases, a number of co-morbid conditions that include an increased fracture risk, renal impairment, peripheral neuropathy, secondary immunodeficiency, and cardiovascular disease. […] Even though the vast majority of the cases of MM arise from a prior state of MGUS, overall, the annual risk of progression from MGUS to symptomatic MM, WM, or other related disorders is only ~1%. Therefore, most patients with MGUS do not progress to symptomatic MM or other lymphoproliferative disorders. However, even in the absence of malignancy and when matched by age and sex, MGUS patients experience shorter overall survival from diagnosis than is expected (8.1 vs. 12.4 years) according to a prospective cohort study. In addition to progression to lymphoproliferative diseases and amyloidosis, patients with MGUS appear to suffer from a greater prevalence of recurrent infections, ischemic heart disease, peripheral neuropathy, and renal diseases compared to those without MGUS.
  • #28
    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. […] The risk of progression for light-chain MGUS is lower when compared to conventional MGUS. […] The importance of MGUS not only lies in the increased risk of developing a hematologic malignancy, but the small clone may also be responsible for severe organ damage through the production of a toxic M-protein which has autoantibody activity or deposits in tissues. […] MGUS patients have an approximately 2-fold increased risk of developing bacterial and viral infections compared to controls. […] MGUS patients have an increased risk of osteoporosis and fractures (axial distal). […] There is an approximately 28-fold increased risk of developing myeloid malignancies including myelodysplastic syndrome (MDS), acute myeloid leukemia, and polycythemia vera in MGUS.
  • #29 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
    Monoclonal gammopathy of undetermined significance (MGUS) is a precancerous condition and the most common plasma cell disorder. Precancerous conditions are not yet cancer, but there is a chance these abnormal changes will eventually become cancer or a related condition. This can take months or years. […] MGUS often doesn’t have any signs or symptoms, but it may cause the following complications: Osteoporosis Some bones may become weak due to the high number of myeloma cells in the bone marrow and cause an increased risk of fractures and bone pain. Infections MGUS affects the immune system and can increase your risk for infections. Peripheral nerve damage (peripheral neuropathy) IgM MGUS may cause tingling or numbness in your hands and feet. […] In general, the risk of MGUS progressing to multiple myeloma is 1% each year and remains 1% each year you live with the disease. So, even 25 years after a diagnosis, the risk of MGUS progressing to multiple myeloma is still 1%.
  • #30 Monoclonal Gammopathy of Undetermined Significance (MGUS)—Not So Asymptomatic after All
    https://www.mdpi.com/2072-6694/12/6/1554
    The aim of this review is to examine the most consistently reported co-morbidities associated with MGUS, namely the increased risk of bone fractures, peripheral neuropathy, renal impairment, secondary immunodeficiency, and cardiovascular disease. […] While lytic bone lesions are a defining feature of symptomatic MM, a number of population-based studies have demonstrated an association between MGUS and low bone mineral density/osteoporosis, which, in turn, increases the risk of fractures within, or close to the axial skeleton. […] The occurrence of a non-traumatic fracture in the context of MGUS requires careful assessment by a hematologist with access to cross-sectional imaging and a bone marrow biopsy to exclude a myeloma-defining event. […] The association between monoclonal paraproteinemia and neuropathy has been demonstrated in a population-based screening study, which found a higher than expected prevalence of peripheral neuropathy.
  • #31 Monoclonal Gammopathy of Undetermined Significance (MGUS)—Not So Asymptomatic after All
    https://www.mdpi.com/2072-6694/12/6/1554
    The absolute prevalence of peripheral neuropathy appears to be under 5% of MGUS patients. […] Peripheral neuropathy affects up to 20% of patients with AL amyloidosis. […] Given that the prevalence of MGUS is 3% in people over the age of 50, distinguishing causality from a correlation of MGUS to peripheral neuropathy is a diagnostic challenge, as the presence of a monoclonal protein in a patient with neuropathy does not necessarily mean that they are related. […] MGUS is a recognized cause of secondary antibody deficiency. The prevalence of MGUS increases with age, as does an age-related decline in immune function, or immunosenescence. […] The increase in risk was not influenced by the paraprotein isotype but was positively correlated with the M-protein concentration. […] The majority of patients with MGUS are over the age of 65, and even in healthy individuals, the immune response to vaccination declines with age.
  • #32
    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. […] The risk of progression for light-chain MGUS is lower when compared to conventional MGUS. […] The importance of MGUS not only lies in the increased risk of developing a hematologic malignancy, but the small clone may also be responsible for severe organ damage through the production of a toxic M-protein which has autoantibody activity or deposits in tissues. […] MGUS patients have an approximately 2-fold increased risk of developing bacterial and viral infections compared to controls. […] MGUS patients have an increased risk of osteoporosis and fractures (axial distal). […] There is an approximately 28-fold increased risk of developing myeloid malignancies including myelodysplastic syndrome (MDS), acute myeloid leukemia, and polycythemia vera in MGUS.
  • #33
    https://haematologica.org/article/view/7062
    Furthermore, MGUS patients have an approximately 1.5-fold increased risk of developing a non-hematologic malignancy. […] Several studies report an approximately 23-fold increased risk of developing deep venous thrombosis or pulmonary embolism in MGUS patients. […] The increased risk of venous and arterial thrombosis was only observed in IgG and IgA MGUS, but not in IgM MGUS. […] MGUS patients have a poorer survival than the general population. […] Sometimes the small clone in MGUS is responsible for severe organ damage through the production of an M-protein which has autoantibody activity or deposits in tissues. […] The M-protein seems to play a role in the development of several skin disorders including plane xanthoma and Schnitzler syndrome. […] Various kidney disorders are the result of toxic M-proteins produced by the MGUS clone, including monoclonal immunoglobulin deposition disease (MIDD, which includes light-chain deposition disease (LCDD), heavy-chain deposition disease (HCDD), and light- and heavy-chain deposition disease (LHCDD)).
  • #34
    https://haematologica.org/article/view/7062
    Furthermore, MGUS patients have an approximately 1.5-fold increased risk of developing a non-hematologic malignancy. […] Several studies report an approximately 23-fold increased risk of developing deep venous thrombosis or pulmonary embolism in MGUS patients. […] The increased risk of venous and arterial thrombosis was only observed in IgG and IgA MGUS, but not in IgM MGUS. […] MGUS patients have a poorer survival than the general population. […] Sometimes the small clone in MGUS is responsible for severe organ damage through the production of an M-protein which has autoantibody activity or deposits in tissues. […] The M-protein seems to play a role in the development of several skin disorders including plane xanthoma and Schnitzler syndrome. […] Various kidney disorders are the result of toxic M-proteins produced by the MGUS clone, including monoclonal immunoglobulin deposition disease (MIDD, which includes light-chain deposition disease (LCDD), heavy-chain deposition disease (HCDD), and light- and heavy-chain deposition disease (LHCDD)).
  • #35 Monoclonal Gammopathy of Undetermined Significance (MGUS)—Not So Asymptomatic after All
    https://www.mdpi.com/2072-6694/12/6/1554
    A retrospective cohort study matched for age and sex found that patients with non-IgM MGUS experienced an increased risk of arterial diseases compared to controls, but a significantly lower risk compared to patients with MM. […] The mortality rate from CVD in MGUS patients has been repeatedly reported to be increased compared to matched controls without MGUS.
  • #36 Monoclonal Gammopathy of Undetermined Significance (MGUS)—Not So Asymptomatic after All
    https://www.mdpi.com/2072-6694/12/6/1554
    The absolute prevalence of peripheral neuropathy appears to be under 5% of MGUS patients. […] Peripheral neuropathy affects up to 20% of patients with AL amyloidosis. […] Given that the prevalence of MGUS is 3% in people over the age of 50, distinguishing causality from a correlation of MGUS to peripheral neuropathy is a diagnostic challenge, as the presence of a monoclonal protein in a patient with neuropathy does not necessarily mean that they are related. […] MGUS is a recognized cause of secondary antibody deficiency. The prevalence of MGUS increases with age, as does an age-related decline in immune function, or immunosenescence. […] The increase in risk was not influenced by the paraprotein isotype but was positively correlated with the M-protein concentration. […] The majority of patients with MGUS are over the age of 65, and even in healthy individuals, the immune response to vaccination declines with age.
  • #37 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 doesn’t always progress to multiple myeloma or other related conditions. Many people living with MGUS are in good health and the disease remains stable. […] 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. […] 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.
  • #38 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
    https://www.nature.com/articles/leu201060
    Monoclonal gammopathy of undetermined significance (MGUS) was identified in 3.2% of 21463 residents of Olmsted County, Minnesota, 50 years of age or older. The risk of progression to multiple myeloma, Waldenstrom’s macroglobulinemia, AL amyloidosis or a lymphoproliferative disorder is approximately 1% per year. Low-risk MGUS is characterized by having an M protein 15g/l, IgG type and a normal free light chain (FLC) ratio. Patients should be followed with serum protein electrophoresis at six months and, if stable, can be followed every 2-3 years or when symptoms suggestive of a plasma cell malignancy arise. Patients with intermediate and high-risk MGUS should be followed in 6 months and then annually for life. The risk of smoldering (asymptomatic) multiple myeloma (SMM) progressing to multiple myeloma or a related disorder is 10% per year for the first 5 years, 3% per year for the next 5 years and 12% per year for the next 10 years. Testing should be done 2-3 months after the initial recognition of SMM. If the results are stable, the patient should be followed every 4-6 months for 1 year and, if stable, every 6-12 months.
  • #39 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 doesn’t always progress to multiple myeloma or other related conditions. Many people living with MGUS are in good health and the disease remains stable. […] 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. […] 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.
  • #40 Risk of MGUS Progression to Myeloma Can Change – NCI
    https://www.cancer.gov/news-events/cancer-currents-blog/2019/mgus-multiple-myeloma-progression-risk
    These recommendations assume that the risk of progression stays constant, Dr. Munshi and his colleagues wrote. […] However, if the risk of MGUS progression changed over time, someone whose disease initially appears to be low risk and opts for no follow-up could develop high-risk MGUS and need more intensive follow-up. […] 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. […] A potential benefit of annual blood testing is that it could lead to earlier detection of multiple myeloma, which could lessen or prevent severe myeloma-related complications like a bone fracture or kidney failure, Dr. Landgren said. […] A remaining issue is that there are limitations to using the standard blood markers to assess MGUS progression, the editorialists noted. […] Drs. Landgren and Hofmann are exploring other markers that may be more predictive of progression to myeloma.
  • #41 Monoclonal gammopathy of undetermined significance (MGUS) – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/mgus/diagnosis-treatment/drc-20352367
    Because MGUS usually causes no symptoms, people who have it usually find out by chance during blood tests for other reasons. […] Symptoms to watch for include: Bone pain. Tiredness or weakness. Weight loss without trying. Fever or night sweats. Headache, dizziness, nerve pain, or changes in vision or hearing. Bleeding. Anemia or other blood irregularities. Swollen lymph nodes, liver or spleen. […] 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.
  • #42 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 cause any symptoms. But a small number of people with MGUS have problems with their balance, or numbness or tingling in their hands and feet. This is called peripheral neuropathy. Symptoms may be because of damage to their nerves caused by paraproteins in the blood. […] 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. […] Some people may also have problems with the kidneys.
  • #43 Ask the Nurse: monoclonal gammopathy of undetermined significance (MGUS) – Myeloma UK
    https://www.myeloma.org.uk/library/ask-the-nurse-mgus/
    If you experience new symptoms such as pain, particularly in your back or ribs, fatigue, and recurring infections, you should tell your doctor or nurse as soon as possible (within two weeks). You should not wait until their next appointment to tell them. […] Currently, there are no specific treatments to stop MGUS from progressing. However, this is a focus area for our research. […] Unfortunately, doctors do not know why some people with MGUS develop cancer, and others do not. […] Although most MGUS patients will never experience any symptoms and remain well, being told that you (or a loved one) have MGUS, may make you feel anxious or uncertain.
  • #44 Ask the Nurse: monoclonal gammopathy of undetermined significance (MGUS) – Myeloma UK
    https://www.myeloma.org.uk/library/ask-the-nurse-mgus/
    If you experience new symptoms such as pain, particularly in your back or ribs, fatigue, and recurring infections, you should tell your doctor or nurse as soon as possible (within two weeks). You should not wait until their next appointment to tell them. […] Currently, there are no specific treatments to stop MGUS from progressing. However, this is a focus area for our research. […] Unfortunately, doctors do not know why some people with MGUS develop cancer, and others do not. […] Although most MGUS patients will never experience any symptoms and remain well, being told that you (or a loved one) have MGUS, may make you feel anxious or uncertain.
  • #45 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. […] Current guidelines suggest lifelong followup in patients with MGUS, so that malignant transformation can be identified early, before the onset of serious complications. […] With IgM MGUS, which poses a high risk for malignant progression, some experts recommend more intensive follow-up, with twice-annual visits that include the following: Clinical assessment, CBC, Comprehensive metabolic panel, Serum protein electrophoresis, Serum FLC assay, Quantitative immunoglobulin serum electrophoresis. […] Autoimmune disease is associated with a lower risk of progression in monoclonal gammopathy of undetermined significance.
  • #46 Risk Stratifying Patients with Monoclonal Gammopathy of Undetermined Significance
    https://consultqd.clevelandclinic.org/risk-stratifying-patients-with-monoclonal-gammopathy-of-undetermined-significance
    Importantly, patients with unexplained bone pain (mostly in long bones, ribs and spine, whereas joints are not typically involved) and a normal skeletal survey should undergo advanced imaging (whole-body magnetic resonance imaging or whole-body positron emission tomography and computed tomography) to detect bone lesions otherwise missed on plain radiography. […] Suspect malignant progression if the serum M protein level increases by 50 percent or more (with an absolute increase of 0.5 g/dL); the serum M protein level is 3 g/dL or higher; the serum free light-chain ratio is more than 100; or the patient has unexplained anemia, elevated creatinine, bone pain, fracture or hypercalcemia. […] The importance of educating patients to report any new worrisome symptom (e.g., fatigue, neuropathy, weight loss, night sweats, bone pain) cannot be overemphasized, as some patients may progress to myeloma or other disorders between follow-up visits.
  • #47 Monoclonal Gammopathy of Undetermined Significance – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK507880/
    Non-IgM MGUS is considered a preneoplastic condition with an annual risk of progression of approximately 1%. The risk of progression is increased when M protein greater than or equal to 15 g/L and with an abnormal free light chain ratio. Non-IgM MGUS does not require treatment. However, the management of patients with non-IgM MGUS requires an understanding of the risk of progression of the disease. Generally, close follow-up is recommended for these patients. […] Monoclonal gammopathy of undetermined significance (MGUS) can progress to develop myeloproliferative disorders or other serious conditions such as multiple myeloma, light chain amyloidosis, Waldenstrom macroglobulinemia, lymphoma, osteoporosis, and venous thromboembolism.
  • #48 MGUS and Multiple Myeloma
    https://www.webmd.com/cancer/multiple-myeloma/mgus-multiple-myeloma
    The only concern is that about 1%/year of people with MGUS go on to develop MM (blood cancer). […] MGUS isnt treated because there is no treatment. Also, treating MGUS has not been shown to lower the risk of progression to cancer. That said, most people who have it live a normal life with no problems. Still, its important to check with your doctor about how often you should come in for monitoring.
  • #49 Ask the Nurse: monoclonal gammopathy of undetermined significance (MGUS) – Myeloma UK
    https://www.myeloma.org.uk/library/ask-the-nurse-mgus/
    If you experience new symptoms such as pain, particularly in your back or ribs, fatigue, and recurring infections, you should tell your doctor or nurse as soon as possible (within two weeks). You should not wait until their next appointment to tell them. […] Currently, there are no specific treatments to stop MGUS from progressing. However, this is a focus area for our research. […] Unfortunately, doctors do not know why some people with MGUS develop cancer, and others do not. […] Although most MGUS patients will never experience any symptoms and remain well, being told that you (or a loved one) have MGUS, may make you feel anxious or uncertain.
  • #50 Monoclonal Gammopathy of Undetermined Significance (MGUS) and Peripheral Neuropathy (PN) | MyMyelomaTeam
    https://www.mymyelomateam.com/resources/mgus-and-peripheral-neuropathy
    Peripheral neuropathy (PN) weakness, numbness, or pain related to nerve damage is a common symptom of clonal plasma disorders. […] Some people with MGUS face symptoms including numbness, balance issues, or tingling in their hands or feet, which often feels like pins and needles. This sensation results from peripheral neuropathy and is often the first indication that something is wrong. […] A person living with MGUS can be expected to develop peripheral neuropathy. That said, having PN does not necessarily indicate a more severe health issue. […] MGUS typically causes no symptoms, so detection of the condition usually happens by chance when a person’s blood is tested for other reasons. […] Certain symptoms or complications caused by MGUS can be treated, however. If a person experiences severe PN, a doctor may prescribe medication. […] If you have peripheral neuropathy from MGUS, you should ask a neurology specialist what treatment options are available for you.
  • #51
    https://link.springer.com/article/10.1007/s12325-022-02125-1
    Although dedicated studies are currently very limited, it would appear that there may be hope for reducing progression of monoclonal gammopathy of undetermined significance to multiple myeloma with metformin in type 2 diabetes mellitus. […] It would appear that there may be hope for reducing progression of MGUS to multiple myeloma with metformin in T2DM. […] However, more data is needed, until we reach a clearer view of what is to be gained with metformin in this setting. […] In conclusion, it is being discussed that metformin may contribute to reduced progression of MGUS to multiple myeloma in subjects with T2DM. However, data is very limited for the moment and we need to know a lot more before we reach a definitive answer.
  • #52 Risk Stratifying Patients with Monoclonal Gammopathy of Undetermined Significance
    https://consultqd.clevelandclinic.org/risk-stratifying-patients-with-monoclonal-gammopathy-of-undetermined-significance
    Importantly, patients with unexplained bone pain (mostly in long bones, ribs and spine, whereas joints are not typically involved) and a normal skeletal survey should undergo advanced imaging (whole-body magnetic resonance imaging or whole-body positron emission tomography and computed tomography) to detect bone lesions otherwise missed on plain radiography. […] Suspect malignant progression if the serum M protein level increases by 50 percent or more (with an absolute increase of 0.5 g/dL); the serum M protein level is 3 g/dL or higher; the serum free light-chain ratio is more than 100; or the patient has unexplained anemia, elevated creatinine, bone pain, fracture or hypercalcemia. […] The importance of educating patients to report any new worrisome symptom (e.g., fatigue, neuropathy, weight loss, night sweats, bone pain) cannot be overemphasized, as some patients may progress to myeloma or other disorders between follow-up visits.
  • #53 MGUS and blood cancer | Blood Cancer UK
    https://bloodcancer.org.uk/understanding-blood-cancer/mgus/mgus-blood-cancer/
    People with MGUS have a higher chance than normal of developing blood cancer, but it is rare for MGUS to turn into blood cancer. […] The chance of someone with MGUS developing blood cancer is known as their risk of progression. Research suggests that each year about one in a hundred people (1%) with a diagnosis of MGUS will develop blood cancer. […] If MGUS progresses, it usually develops into a blood cancer called myeloma. Theres no cure for myeloma yet, but it is treatable. Most people with myeloma will have periods of treatment followed by periods of remission, where theres a low level of cancer cells and they feel well. […] Its important to remember that very few people with MGUS go on to get blood cancer. […] You may feel anxious about developing blood cancer, even if your risk of progression is low. This is completely understandable.
  • #54 MGUS – Myeloma UK
    https://www.myeloma.org.uk/understanding-myeloma/related-conditions/mgus/
    MGUS is not associated with any symptoms, so the abnormal protein is usually discovered when tests are being performed to rule out other health issues. […] Your healthcare team will monitor you for any signs that your MGUS may be developing into another condition. […] Keeping an eye out and reporting any symptoms, including fatigue, pain, recurrent or frequent infections, and fractures, will help them build a full understanding of your condition. […] 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.
  • #55 „Understanding MGUS: Monoclonal Gammopathy of Undetermined Significance” – Longmore Clinic
    https://longmoreclinic.org/understanding-mgus-monoclonal-gammopathy-of-undetermined-significance/
    If you experience any new or unusual symptoms, such as unexplained pain, weakness, numbness, or fatigue, it is important to seek medical attention. These symptoms may indicate progression to a more serious disorder or the development of complications related to MGUS. […] In conclusion, MGUS is a relatively common condition that, while typically asymptomatic, requires regular monitoring due to the potential for progression to more serious disorders. Understanding MGUS, its risk factors, and how to manage it can help minimize the risk of complications and ensure timely intervention if the condition progresses. If you have been diagnosed with MGUS, work closely with your healthcare provider to develop a monitoring and management plan tailored to your individual needs.

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