Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management.
Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management.
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DOI：
10.1038/leu.2010.60
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发表时间：
2010-06
期刊：
影响因子：
11.4
通讯作者：
International Myeloma Working Group
中科院分区：
文献类型：
--
作者：
Kyle RA;Durie BG;Rajkumar SV;Landgren O;Blade J;Merlini G;Kröger N;Einsele H;Vesole DH;Dimopoulos M;San Miguel J;Avet-Loiseau H;Hajek R;Chen WM;Anderson KC;Ludwig H;Sonneveld P;Pavlovsky S;Palumbo A;Richardson PG;Barlogie B;Greipp P;Vescio R;Turesson I;Westin J;Boccadoro M;International Myeloma Working Group
在明尼苏达州奥姆斯特德县21463名50岁及以上居民中，有3.2%被确诊为意义未明的单克隆丙种球蛋白病（MGUS）。进展为多发性骨髓瘤、瓦尔登斯特伦巨球蛋白血症、AL淀粉样变性或淋巴增殖性疾病的风险约为每年1%。低危MGUS的特征是M蛋白<15 g/L、IgG型且游离轻链（FLC）比值正常。患者应在6个月时进行血清蛋白电泳检查，如果病情稳定，可每2 - 3年检查一次，或者在出现提示浆细胞恶性肿瘤的症状时进行检查。中危和高危MGUS患者应在6个月时进行检查，之后终身每年检查一次。冒烟型（无症状）多发性骨髓瘤（SMM）进展为多发性骨髓瘤或相关疾病的风险在最初5年为每年10%，接下来5年为每年3%，再接下来10年为每年1 - 2%。应在首次确诊SMM后2 - 3个月进行检测。如果结果稳定，患者应在1年内每4 - 6个月检查一次，如果仍然稳定，则每6 - 12个月检查一次。
Monoclonal gammopathy of undetermined significance (MGUS) was identified in 3.2% of 21 463 residents of Olmsted County, Minnesota, 50 years of age or older. The risk of progression to multiple myeloma, Waldenstrom’s macroglobulinemia, AL amyloidosis or a lymphoproliferative disorder is approximately 1% per year. Low-risk MGUS is characterized by having an M protein <15 g/l, IgG type and a normal free light chain (FLC) ratio. Patients should be followed with serum protein electrophoresis at six months and, if stable, can be followed every 2–3 years or when symptoms suggestive of a plasma cell malignancy arise. Patients with intermediate and high-risk MGUS should be followed in 6 months and then annually for life. The risk of smoldering (asymptomatic) multiple myeloma (SMM) progressing to multiple myeloma or a related disorder is 10% per year for the first 5 years, 3% per year for the next 5 years and 1–2% per year for the next 10 years. Testing should be done 2–3 months after the initial recognition of SMM. If the results are stable, the patient should be followed every 4–6 months for 1 year and, if stable, every 6–12 months.
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