Monoclonal Gammopathy of Uncertain Significance MGUS

Definition and epidemiology (nefm 2006:355 2765)

• M component < 3 g dl. no urinary Bence Jones proteins, marrow plasmacytosis <10%.

and no lytic bone lesions, anemia, hypercalcemia, or renal insufficiency

• Prevalence 3% in population >50 y of age. 5% in population >70 y of age. and

7.5% in population -85 y of age (nejm 2006:354:1362) Management

• ✓ CBC. Ca. Cr. SPEP and UPEP with immunofixation to exclude MM

• Close observation: repeat SPEP in 6 mos and then yearly thereafter if stable Prognosis (nejm 2002 346:564)

• 1% y or 25% lifetime risk — MM.WM. amyloidosis, or malign, lymphoproliferative dis.

• Abnormal serum-free light chain ratio associated w i risk of progression to MM (Stood

2005:105812)

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