Insight

Vincent Rajkumar: MGUS is common and can cause lots of problems

Vincent Rajkumar/X

Jan 8, 2025, 15:44

Vincent Rajkumar: MGUS is common and can cause lots of problems

Vincent Rajkumar, Professor of Medicine at the Mayo Clinic, shared a post on X:

“MGUS is common and can cause lots of problems. Important for all physicians to know the 5 main scenarios.

1) MGUS that’s just MGUS, and nothing more. Associated with nothing else (this is by far the most common scenario).

2) MGUS that is seemingly associated with some disease but in reality it is a red herring, an unrelated coincidental association (this is the second most common scenario). Remember 5% of every single disease in adults over age 50 will have MGUS if you look for it). It’s just common and coincidental.

3) MGUS that at some point progresses to malignancy (myeloma, plasmacytoma, Waldenstroms). Important to recognize in a timely manner.

4) MGUS where biologically it’s just MGUs, but simply bad luck the nature of the monoclonal protein (amino acid sequence and protein structure) causes certain specific diseases that nothing else causes (AL amyloidosis, Type I cryo, light chain deposition disease)

5) MGUS where simply by luck the nature of the monoclonal protein (amino acid sequence and protein structure) causes certain diseases that can also be caused by a zillion other conditions (eg., peripheral neuropathy, glomerulonephritis, blood clots, and more ) — here is where you need lots of good testing and judgment to decide that the cause is indeed MGUS and not something else, and even if it is MGUS judgment as to whether any kind of clone directed treatment will help or will be even worse than the disease you are trying to treat.”

Vincent Rajkumar is a Professor of Medicine at the Mayo Clinic in Rochester, Minnesota, and Chair for the Mayo Clinic Myeloma, Amyloidosis, and Dysproteinemia Group. He also chairs the Board of directors of The International Myeloma Foundation and the Eastern Cooperative Oncology Group (ECOG) Myeloma Committee.

His extensive contributions include over 230 peer-reviewed publications, predominantly focusing on multiple myeloma and related plasma cell disorders. Furthermore, Dr. Rajkumar is a Section Editor for multiple myeloma and related disorders for Leukemia and an Associate Editor for the Mayo Clinic Proceedings.