Materiały źródłowe

• #1 Prevention of Progression in Monoclonal Gammopathy of Undetermined Significance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2759099/

  Monoclonal gammopathy of undetermined significance (MGUS) is a common premalignant plasma cell proliferative disorder with a lifelong risk of progression to multiple myeloma. […] Strategies to delay or prevent progression in high-risk patients are of considerable importance. […] Recent studies show that myeloma is almost always preceded by MGUS, lending additional impetus for testing preventive strategies such as the one undertaken by Golombick et al for patients with MGUS who are at high risk of progression. […] Any preventive strategy for MGUS, including trials with relatively non toxic agents such as curcumin need to consider the absolute risk of progression to malignancy. […] Phase III studies with curcumin and other preventive strategies should be focused on patients who are at the highest risk of progression.

• #2

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

  Monoclonal gammopathy of undetermined significance is one of the most common pre-malignant disorders. […] There are currently no interventions to prevent or delay progression of MGUS. Intervention approaches should only be performed in the setting of a clinical trial. […] 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). […] 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. […] The risk of progression for light-chain MGUS is lower when compared to conventional MGUS.

• #3 Monoclonal Gammopathy of Undetermined Significance (MGUS)

  https://my.clevelandclinic.org/health/diseases/17744-monoclonal-gammopathy-of-undetermined-significance-mgus

  No, you cant prevent this condition. It happens when certain genes mutate, creating abnormal plasma cells that produce the abnormal proteins that cause MGUS symptoms. […] While MGUS rarely becomes cancerous, your provider will monitor M protein levels in your blood and urine (pee) every six to 12 months for signs of cancer. Sometimes, people with this condition have an increased risk of bone loss or fracture. If youre at risk, your provider may recommend medications and other steps to improve bone density.

• #4 Benign monoclonal gammopathy (monoclonal gammopathy of unknown significance) – Cancer Therapy Advisor

  https://www.cancertherapyadvisor.com/home/decision-support-in-medicine/hospital-medicine/benign-monoclonal-gammopathy-monoclonal-gammopathy-of-unknown-significance/

  Because MGUS will progress to multiple myeloma or another malignancy at a rate of 1% per year, most patients require follow up every 6-12 months. […] For patients with a non-IgG monoclonal protein (such as IgA or IgD) or a very high quantity of M spike on SPEP, the rate of progression is higher such that closer follow up is usually required. […] As MGUS is a pre-malignant condition, the provider must notify patients as to the risk of progression to a symptomatic disease that requires treatment. […] While the risk of transformation from MGUS to myeloma is low, it is not the same for all types of MGUS. […] Patients with a higher M spike (greater than 1.5 g/dL) or abnormal SFLC ratio are at a higher risk of disease progression. […] A rough number to quote to patients is that 1% of patients per year with MGUS will develop myeloma or a related disorder. […] The only patient counseling that is needed for this disorder is simply for patients to know that while MGUS is asymptomatic, they should be aware of the need for follow-up lab testing to evaluate for disease progression.

• #5 Monoclonal Gammopathy of Unknown Significance (MGUS) | UAMS Health

  https://uamshealth.com/condition/monoclonal-gammopathy-of-unknown-significance/

  Monoclonal Gammopathy of Undetermined Significance (MGUS) is a non-cancerous, or benign, condition characterized by the presence in the blood of an abnormal protein produced by plasma cells. […] MGUS is considered a benign condition, since there is only a small risk that it will develop into myeloma or a related blood cancer. […] MGUS does not usually require treatment. In most people, MGUS remains stable and does not ever cause any problems. However, because MGUS can develop into myeloma, regular check-ups are important. […] Regular check-ups are essential, since myeloma typically develops in 1% to 2% of MGUS patients per year. […] Research at the Myeloma Center suggests that some patients with MGUS are at increased risk for progression to myeloma. Risk is based on clinical variables, such as blood protein levels and results of gene expression profiling and magnetic resonance imaging. In some cases, treatment aimed at preventing progression to active myeloma is indicated.

• #6

  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. […] There are currently no data available on extrinsic factors that promote progression. […] So far no predictive factors for progression have been identified for light-chain MGUS. […] The risk of thrombosis did not vary by M-protein level in one study, whereas in two studies risk of venous thrombosis was increased in patients with higher M-protein levels. […] The increased risk of venous and arterial thrombosis was only observed in IgG and IgA MGUS, but not in IgM MGUS. […] These recommendations are personalized and based on both life expectancy and risk of progression.

• #7 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. […] These recommendations assume that the risk of progression stays constant, Dr. Munshi and his colleagues wrote.

• #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

  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. Without annual testing, the patient would be unaware of this change. […] 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.

• #9 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 usually develops in people 70 years of age or older. Black men (including men of African ancestry) and people with a family history of MGUS or multiple myeloma have a higher chance of developing MGUS. […] 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. […] 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. […] 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.

• #10 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. […] If clinical trials of preventive strategies are available, patients at high risk for progression should be encouraged to participate. […] Current guidelines suggest lifelong followup in patients with MGUS, so that malignant transformation can be identified early, before the onset of serious complications. […] Followup schedules in patients with MGUS can be based on risk stratification. […] 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. […] The European Myeloma Network advises that for low-risk MGUS, follow-up at 6 months and every 12 years thereafter can be justified. […] In patients who are elderly or have significant morbidity with a short life expectancy, it may be reasonable to forgo follow-up.

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

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

  Another benefit of early detection is earlier treatment with new, highly efficacious drugs which can translate into deep, sustained treatment responses, Dr. Landgren said, including those that are negative for minimal residual disease. […] 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.

• #12 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?ContentTypeID=134&ContentID=121

  The most common condition linked with these abnormal proteins is monoclonal gammopathy of undetermined significance (MGUS). […] MGUS does not usually cause symptoms, so it doesn’t need to be treated. Since MGUS may lead to a more serious condition, regular monitoring and checkups are recommended throughout your life. This often includes regular physical exams and blood tests. This will help find problems as early as possible. […] MGUS may lead to a more serious condition. So checkups may be recommended throughout your life to find problems as early as possible.

• #13 Can You Prevent MGUS From Progressing? | MyMyelomaTeam

  https://www.mymyelomateam.com/resources/can-you-prevent-mgus-from-progressing

  Monoclonal gammopathy of undetermined significance (MGUS) is a noncancerous condition in which plasma cells release an abnormal protein into the blood. For many people living with MGUS, their biggest concern is that the condition will evolve into multiple myeloma, a type of blood cancer. […] There is no proven way to prevent the progression of MGUS into multiple myeloma. However, researchers are testing new treatments to slow or stop its progression to multiple myeloma. […] Whether or not you attend a specialty clinic, be honest with your health care team about your symptoms, concerns, and plans. Your health team can discuss the risks and benefits of possible preventive measures. […] Treating multiple myeloma is difficult. Doctors and scientists hope to find ways to prevent MGUS from evolving into multiple myeloma. Clinical trials research studies evaluating treatment effectiveness on people are underway to test prescription medications and lifestyle interventions.

• #14 A Randomized, Double-Blind, Placebo-Controlled Phase 2 Study of Metformin for the Prevention of Progression of Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple Myeloma | Dana-Farber Cancer Institute

  https://www.dana-farber.org/clinical-trials/21-008

  The purpose of this research is to understand whether the drug metformin could be used in the future to help prevent patients with monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) from developing multiple myeloma. […] – Diagnosed with higher-risk MGUS or low-risk SMM defined below: […] – Low-Risk Smoldering Myeloma: bone marrow plasma cells 10%# with the absence of additional high-risk features, which are further defined in the exclusion criteria. […] Participants with CRAB criteria that are attributable to conditions other than the disease under study may be eligible.

• #15 Funded Grants | Division of Cancer Prevention

  https://prevention.cancer.gov/funding-and-grants/funded-grants/R01CA253475

  Multiple myeloma (MM) is uniformly preceded by monoclonal gammopathy of undetermined significance (MGUS). The current management for MGUS is watchful waiting for disease progression. […] We therefore hypothesize that metformin use in MGUS patients will prevent MM and reduce MM disparities. […] The long-term goal is to identify intervention strategies to prevent the progression of MGUS to MM, reduce the overall burden of MM, and reduce MM disparities. […] This project is significant in its capability to 1) identify perhaps the only modifiable risk factor (high BMI) to inform interventions to prevent MM; 2) identify a dynamic marker for disease progression by race (M-protein concentration), where these biomarkers can be a surrogate for MM diagnosis in future prevention trials; and 3) reduce MM health disparities by a) identifying race-specific biomarkers for MGUS and MGUS progression, available through clinical encounters (as opposed to expensive genetic testing); and b) exploring metformin use as a chemopreventive measure. […] Successful completion of this study will provide evidence for a paradigm shift in current clinical practice of MGUS management and help prevent MM, an incurable and costly disease. More importantly, it will provide evidence to guide interventions to reduce MM disparities.

• #16 Prevention of Progression in Monoclonal Gammopathy of Undetermined Significance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2759099/

  Patients with high-risk MGUS, and patients with biologic MGUS clinically identified as SMM are candidates for preventive strategies including phase III trials with curcumin. […] With the increasing availability of novel targeted therapies for myeloma, phase III clinical trials are ongoing to determine if the early use of drugs such as lenalidomide or bisphosphonates can delay progression in MGUS and SMM. […] Subsequent trials need to focus on those at the highest risk of progression.

• #17 Monoclonal Gammopathy of Undetermined Significance (MGUS)—Not So Asymptomatic after All

  https://www.mdpi.com/2072-6694/12/6/1554

  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 use of bisphosphonates in patients with MGUS with reduced bone mineral density is associated with a reduced risk of fractures. […] In the absence of further risk stratification for fractures in the context of MGUS, oral bisphosphonates are indicated when osteoporosis is identified. […] The European Myeloma Network suggests that for patients with reduced bone mineral density or a history of non-traumatic fracture, bisphosphonate therapy, as well as replacement of calcium and vitamin D, are indicated. […] MGUS is a recognized cause of secondary antibody deficiency. […] A history of, particularly sinopulmonary, infections should be sought in patients with MGUS, and for whom associated hypogammaglobulinemia may be contributory.

• #18 Artificial intelligence-enabled screening strategy for drug repurposing in monoclonal gammopathy of undetermined significance | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00798-7

  Monoclonal gammopathy of undetermined significance (MGUS) is a benign hematological condition with the potential to progress to malignant conditions including multiple myeloma and Waldenstrom macroglobulinemia. […] While previous research has identified certain laboratory findings that are predictive of MGUS progression risk, there are currently no medications identified that can decrease progression risk. […] More recently, clinical trials are underway studying daratumumab, cancer vaccines and rifaximin for early intervention in MGUS. […] In addition to traditional clinical trials, drug repurposing may offer another strategy for discovering potential treatments for conditions where none exist, such as MGUS. […] We propose that the results of a screening analysis such as this could then be used to inform more in-depth studies such as synthetic clinical trials or traditional clinical trials.

• #19 Can You Prevent MGUS From Progressing? | MyMyelomaTeam

  https://www.mymyelomateam.com/resources/can-you-prevent-mgus-from-progressing

  Other studies are investigating how diet and lifestyle changes may help lower the risk of progression. […] However, there is not yet enough evidence to suggest that people with MGUS should take curcumin supplements. Before starting a new supplement, you should also speak with your health care provider. […] Another study, published in 2017, found that being overweight or obese was a risk factor for progression from MGUS to multiple myeloma. […] A trial launched in 2021 was designed to provide a whole-food, plant-based diet for 12 weeks to overweight or obese adults with MGUS or smoldering myeloma. Doctors would then monitor participants weight loss and ability to stick to the diet, as well as clinical markers of MGUS and myeloma.

• #20 Artificial intelligence-enabled screening strategy for drug repurposing in monoclonal gammopathy of undetermined significance | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00798-7

  Our model achieved a good fit of the data with inverse probability of censoring weights concordance index of 0.883. […] The presence of multivitamins, immunosuppression, non-coronary NSAIDS, proton pump inhibitors, vitamin D supplementation, opioids, statins and beta-blockers were associated with significantly lower hazard ratio for MGUS progression in our primary model; multivitamins and non-coronary NSAIDs remained significant across both sensitivity analyses. […] This study represents the first application of machine-learning for screening drug repurposing candidates in MGUS. […] We uncovered associations that have been previously suggested (better hematologic malignancy outcomes with statin and beta-blocker use) and others that have not (decreased risk of progression with proton pump inhibitor use). […] Future research should focus on prospectively investigating these associations and applying similar methodology to other disease states.

• #21 „Understanding MGUS: Monoclonal Gammopathy of Undetermined Significance” – Longmore Clinic

  https://longmoreclinic.org/understanding-mgus-monoclonal-gammopathy-of-undetermined-significance/

  Monoclonal Gammopathy of Undetermined Significance (MGUS) is a condition characterized by the presence of an abnormal protein, called a monoclonal protein or M protein, in the blood. […] MGUS is considered a plasma cell disorder, as it is caused by abnormal plasma cells in the bone marrow producing an excess of a single type of immunoglobulin (monoclonal protein). […] MGUS is typically asymptomatic, meaning it doesn’t cause any noticeable symptoms. […] There are no known measures to specifically prevent MGUS. However, maintaining a healthy lifestyle and managing any underlying health conditions may help reduce the risk of developing MGUS and its potential complications.

• #22 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. […] 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. […] 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.

• #23 Monoclonal Gammopathy of Undetermined Significance – MD Searchlight

  https://mdsearchlight.com/blood-disorders/monoclonal-gammopathy-of-undetermined-significance/

  People with a condition called monoclonal gammopathy of undetermined significance (MGUS) wont necessarily need specific treatment. However, they should regularly check in with their doctor every six to twelve months for thorough health examinations, alongside certain blood and urine tests. This is to monitor any possible changes or progress in their condition. […] For patients experiencing bone thinning (osteopenia) or bone weakening (osteoporosis), a type of treatment known as bisphosphonate therapy might be beneficial. This therapy helps to slow down or prevent bone damage.

• #24 Monoclonal Gammopathy of Undetermined Significance (MGUS)—Not So Asymptomatic after All

  https://www.mdpi.com/2072-6694/12/6/1554

  Protecting immunocompromised patients against vaccine-preventable infectious disease is an opportunity to prevent morbidity and perhaps mortality that is frequently missed. […] The current standard of care for patients with MGUS or SMM is observation, and during this time, it is important to remember routine vaccination against common infectious diseases during routine follow-up care, so-called ‘watch, wait, and vaccinate’. […] The aim of this review is to consolidate current evidence for the significance of these co-morbidities before considering how best to approach these symptoms and signs, which are often encountered in primary care or within a number of specialties in secondary care.

• #25 Monoclonal Gammopathy of Undetermined Significance (MGUS)

  https://www.verywellhealth.com/monoclonal-gammopathy-of-undetermined-significance-4771132

  Be sure to let your healthcare provider know right away if you notice any new unexplained symptoms after you are diagnosed with MGUS. These might include fatigue, nerve or bone pain, weight loss, or night sweats. If you are experiencing any of these, there might be a chance that your MGUS has progressed to a more serious medical condition.

• #26 Monoclonal Gammopathy of Undetermined Significance (MGUS)

  https://www.verywellhealth.com/monoclonal-gammopathy-of-undetermined-significance-4771132

  MGUS is a medical condition that has no symptoms. It is not a cancer, but it does increase the risk of multiple myeloma and sometimes other blood malignancies. […] No treatment is needed for MGUS. However, you will likely need follow-up monitoring to make sure that your MGUS doesn’t develop into a more serious blood disorder. […] It’s important to get this monitoring, if it’s recommended. One of the most serious potential problems from MGUS is the increased risk of multiple myeloma. However, early diagnosis of multiple myeloma might help reduce disease complications and extend your lifetime. […] Through monitoring, you might be able to treat the disease in its earliest stages. As you monitor your MGUS over time, it becomes less and less likely that a more serious blood problem will actually happen.

• #27 CAP-IT Member: MGUS

  https://ncicapit.org/members/mgus/

  Monoclonal Gammopathy of Undetermined Significance (MGUS) is a precancerous condition affecting ~3.5 million Americans. Other than active surveillance, there is no treatment to prevent MGUS from progressing into cancers, the vast majority of which are incurable. […] We hypothesize that cancer-driving molecules and the bone marrow microenvironment promoting MGUS progression are suitable targets for precision cancer prevention and interception. […] Aim 3: Develop new projects for cancer preventive or interceptive interventions against MGUS progression.

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