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Monoclonal gammopathy of unknown significance (MGUS) is an asymptomatic plasma cell disorder, with a propensity to progress to symptomatic MM after 15 to 20 years. In recent years old patientthere have been improvements in risk stratification models (involving molecular markers), which have led to better understanding of the biology and probability of progression of MGUS.
MGUS prognosis
Risk stratification of monoclonal gammopathy of uncertain significance
1. Assess patient for each of three risk factors
- Abnormal serum free light chain ratio (SFLC)
- Serum M protein = 15 g/L
- M protein not of IgG subtype
2. Sum the number of risk factors to determine risk category and prognosis
| Number of factors | Risk category | 20 year progression risk (%) | 20 year progression risk accounting for death as competing factor (%) |
| 0 | Low | 5 | 2 |
| 1 | Low-intermediate | 21 | 10 |
| 2 | High-intermediate | 37 | 18 |
| 3 | High | 58 | |
This prognostic system for monoclonal gammopathy of uncertain significance (MGUS) was developed following a retrospective analysis of serum free light chain (SFLC) ratio of 1148 patients presenting between 1960 and 1994.
1 Each of the three risk factors studied (abnormal SFLC, serum M protein (paraprotein) = 15 g/L, non-IgG paraprotein subtype) carried a hazard ratio of ~2.5 for progression.