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Figures
- Fig 1.
Definition of multiple myeloma and precursor plasma cell disorders, including monoclonal gammopathy of undetermined significance (adapted from International Myeloma Working Group definition).2 CRAB = hypercalcaemia, renal impairment, anaemia, bone disease; MGUS = monoclonal gammopathy of undetermined significance; MRI = magnetic resonance imaging; SFLC = serum free light chain
Tables
- Table 1.
Known complications of MGUS, with relative risk compared with population, proposed underlying mechanism and available treatment optionsa
Complication Risk compared with population Suggested pathological mechanism Potential treatment Fracture14 1.7 Increased osteoclast activity and bone resorption15–18 Bone protection with bisphosphonates Osteoporosis19 ,20 1.2 (or higher) Infection21,22 2.2 Hypogammaglobulinaemia21
Reduction in specific antibody23Early treatment of infective symptoms; vaccinations Renal disease 24,25 Monoclonal Ig deposition disease,24 –26 proliferative glomerulonephritis,27 light-chain proximal tubulopathy 28 Dependent on mechanism: chemotherapy Neuropathy 19,29 5.9 (CIDP) 3.2 (autonomic) Antibodies against myelin-associated glycoprotein (MAG) in myelin sheath of peripheral nerves 30 IV immunoglobulin; chemotherapy; rituximab (in clinical trials) Thrombosis 31 2.1 Inflammation related: raised inflammatory mediators, including IL-6 32 Consideration of thromboprophylaxis in high-risk situations aThe known complications of MGUS, with relative risk compared with the general population given where available from current studies (as referenced) and treatment options.
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What is the significance of monoclonal gammopathy of undetermined significance?
