Evaluation of monoclonal gammopathies

Last reviewed: 7 Apr 2025
Last updated: 31 Mar 2022

Summary

Differentials

Common

  • Monoclonal gammopathy of undetermined significance
  • Chronic lymphocytic leukemia
  • Non-Hodgkin lymphoma
Full details

Uncommon

  • Light chain deposition disease
  • Post-transplant monoclonal gammopathies
  • Multiple myeloma
  • Plasma cell leukemia
  • Waldenstrom macroglobulinemia
  • Solitary plasmacytoma
  • POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes)
  • Hepatitis C
  • HIV infection
  • Primary amyloidosis
  • Cryoglobulinemia
  • Systemic lupus erythematosus (SLE)
  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Sjogren syndrome
  • Schnitzler syndrome
Full details

Contributors

Authors

Shaji Kumar, MD

Mark and Judy Mullins Professor of Hematological Malignancies

Division of Hematology

Mayo Clinic

Rochester

MN

Disclosures

SK has received research funding for clinical trials for his institution from: Abbvie, Amgen, BMS, Carsgen, Janssen, KITE, Merck, Astra-Zeneca, Novartis, Roche-Genentech, Takeda, and Tenebio. SK has participated in consulting and advisory boards (with no personal payment) for Abbvie, Amgen, BMS, Janssen, Roche-Genentech, Takeda, KITE, Astra-Zeneca, Bluebird Bio, and (with personal payment) Oncopeptides, Beigene, and Antengene.

Peer reviewers

Antonio Palumbo, MD

Associate Professor

University of Turin

Chief

Myeloma Unit

Ospedale Molinette

Turin

Italy

Disclosures

AP declares that he has no competing interests.

John R. Wingard, MD

Price Eminent Scholar and Professor of Medicine Director

Bone Marrow Transplant Program

Division of Hematology and Oncology

University of Florida College of Medicine

Gainesville

FL

Disclosures

JRW declares that he has no competing interests.

John Densmore, MD, PhD

Associate Professor of Clinical Medicine

Department of Medicine

Division of Hematology/Oncology

University of Virginia

Charlottesville

VA

Disclosures

JD declares that he has no competing interests.

References

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Key articles

Rajkumar SV, Dispenzieri A, Kyle RA. Monoclonal gammopathy of undetermined significance, Waldenstrom macroglobulinemia, AL amyloidosis, and related plasma cell disorders: diagnosis and treatment. Mayo Clin Proc. 2006 May;81(5):693-703. Abstract

International Myeloma Working Group. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol. 2003 Jun;121(5):749-57. Abstract

Katzmann JA, Dispenzieri A. Screening algorithms for monoclonal gammopathies. Clin Chem. 2008 Nov;54(11):1753-5.Full text  Abstract

Kyle RA, Therneau TM, Rajkumar SV, et al. A long-term study of prognosis in monoclonal gammopathy of undetermined significance. N Engl J Med. 2002 Feb 21;346(8):564-9.Full text  Abstract

Kyle RA, Durie BG, Rajkumar SV, et al; International Myeloma Working Group. 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. 2010 Jun;24(6):1121-7. Abstract

Dispenzieri A, Kyle R, Merlini G, et al; International Myeloma Working Group. International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders. Leukemia. 2009 Feb;23(2):215-24. Abstract

Reference articles

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