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Monoclonal gammopathy of undetermined significance

Last reviewed: 5 Oct 2024
Last updated: 10 May 2023

Summary

Definition

History and exam

Key diagnostic factors

  • at-risk demographic (male, age >50 years, African ancestry)
  • clinically asymptomatic
  • positive family history
  • history of radiation exposure
  • history of pesticide exposure
Full details

Other diagnostic factors

  • history of immunosuppression or infections
  • presence of peripheral neuropathy
Full details

Risk factors

  • male sex
  • age >50 years
  • African ancestry
  • family history of MGUS or multiple myeloma
  • immune-mediated conditions
  • radiation exposure
  • pesticide exposure
Full details

Diagnostic tests

1st tests to order

  • electrophoresis with immunofixation and measurement of serum immunoglobulins
  • CBC with differential
  • serum calcium
  • serum creatinine
  • urinalysis and 24-hour urine collection with electrophoresis and immunofixation
  • serum free light chains assay
  • metastatic bone survey (conventional x-ray or whole body low-dose CT scan)
Full details

Tests to consider

  • bone marrow aspiration and/or biopsy
  • bone mineral density scan
  • MRI scan
  • PET scan
Full details

Treatment algorithm

ONGOING

confirmed MGUS

Contributors

Authors

Shaji Kumar, MD

Professor of Medicine

Division of Hematology

Mayo Clinic

Rochester

MN

Disclosures

SK has received research funding for clinical trials to the institution from Abbvie, Amgen, Allogene, Astra-Zeneca, BMS, Carsgen, GSK, Janssen, Novartis, Roche-Genentech, Takeda and Regeneron. SK has participated in consulting and advisory board activities (with no personal payments) for Abbvie, Amgen, BMS, Janssen, Roche-Genentech, Takeda, Astra-Zeneca, Bluebird Bio, Secura Biotherapeutics, Trillium, Loxo Oncology, K36, Sanofi, ArcellX, and (with personal payment) Oncopeptides, Beigene and Antengene.

Acknowledgements

Professor Shaji Kumar would like to gratefully acknowledge Dr Ola Landgren, a previous contributor to this topic.

Disclosures

OL is an author of several references cited in this topic.

Peer reviewers

Daniel Catovsky, MD

Consultant Haemato-Oncologist

Section of Haemato-Oncology

Brookes Lawley Institute of Cancer

Sutton

UK

Disclosures

DC declares that he has no competing interests.

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