Vincent Rajkumar, Professor of Medicine at the Mayo Clinic in Rochester and Editor‑in‑Chief at Blood Cancer Journal, shared a post on X:
“MGUS – The most important concepts clarified.
- Dr. Kyle called it monoclonal gammopathy of undetermined significance not because he didn’t know its significance. He knew quite well that it can cause progression to malignancy like myeloma and non malignant disorders like amyloidosis. He used the words “undetermined significance” to indicate that for a given patient you don’t know for sure whether it stays benign or progresses to malignancy. Unfortunately without this historical understanding, I see many wrong ideas and terms used.
- MGUS can stay quiet for a lifetime, progress to malignancy, progress to one or more non malignant disorders, or progress to both malignancy and non malignancy in a given patient.
- MGUS is common. Most diseases associated with MGUS are coincidental and not causally related to MGUS. To blame MGUS for a clinical problem you need to have proof and/or fulfill clear criteria.
- We can never predict the future with 100% accuracy. But with good risk stratification models we know who we can almost surely reassure. And who we need to follow closely.
- Let us please leave biological ideas as biological ideas. For clinical purposes there is immense value in separating MGUS from SMM, and to risk stratify MGUS. When there is a patient in front of us, it is wise to know exactly what the probabilities are for serious events happening, and exactly what kind of follow up is needed from whom.”
Title: Monoclonal Gammopathy of Undetermined Significance
Authors: Vincent Rajkumar, Shaji Kumar
Read the Full Article.
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