Sickle Cell Disease (SCD): Practice Essentials, Background, Genetics
Monoclonal Gammopathy Of Undetermined Significance (MGUS)
Monoclonal gammopathy of undetermined significance (MGUS) is not cancer. There's a small risk it can become cancer. Out of every 100 people with MGUS, each year, 1 or 2 of them will get cancer from MGUS.
MGUS (pronounced like EM-gus) is when your blood makes an abnormal (not normal) protein called m-protein. It's a blood disorder that often starts in older people after age 50.
You may be at higher risk for MGUS if you:
We do not know what causes MGUS. There may be a link to autoimmune diseases, genetics, or environmental factors.
Like multiple myeloma, MGUS starts in a type of white blood cell called plasma cells. These cells make m-protein. This abnormal protein can build up in your blood and urine.
Blood and urine tests can show if you have MGUS, or show signs it's getting worse. These tests look for how much m-protein is in your blood, and what kind of m-protein you have.
MGUS signs and symptomsPeople with MGUS do not have symptoms or signs of multiple myeloma. Some people feel peripheral neuropathy (peh-RIH-feh-rul noor-AH-puh-thee). This is numbness, tingling, or pain in your hands and feet.
Living with MGUSMGUS can be precancerous, which means it can become cancer. It can be stable for many years, and then turn into another condition. This change happens with very few people. Most people with MGUS never get a more serious condition.
MGUS can turn into multiple myeloma. It also can turn into another blood disease, either:
If you have MGUS, your protein levels should be monitored through regular blood tests. You will not need treatment for MGUS as long as the level of m-protein does not rise.
Your MSK care team can guide your local healthcare provider as they monitor MGUS.
They will watch to see if MGUS becomes another blood disease. If that happens, your MSK doctors can treat plasma cell disorders or multiple myeloma.
Autoimmune Disorders Independent Of Monoclonal Gammopathy
Monoclonal gammopathy of undetermined significance, or MGUS, was found not to be associated with the presence of autoimmune disorders among more than 75,000 subjects who were screened (1✔ ✔Trusted SourceAssociation Between Autoimmune Diseases and Monoclonal Gammopathy of Undetermined SignificanceGo to source). Monoclonal gammopathies are conditions characterized by the presence of abnormal proteins (antibodies) in the blood, produced by a small number of plasma cells in the bone marrow. The most common condition associated with these abnormal proteins is monoclonal gammopathy of undetermined significance (MGUS). 'New study implies that past links between autoimmune conditions and MGUS may have been influenced by ascertainment bias. #abnormalproteins #thyroid ' The researchers believe that these results are important in terms of clinical practice as they suggest that there may be no need for periodic screening for MGUS among patients with autoimmune diseases. The study appeared in Annals of Internal Medicine.Researchers from the University of Iceland analyzed a cross-sectional study where 75,422 adults were screened for MGUS to see if they could find an association between MGUS and autoimmune diseases. Of those screened, 10,818 had an autoimmune disease, and 599 of the patients with autoimmune diseases had MGUS.
There were no differences between organ-specific and systemic autoimmune diseases or between antibody-positive and antibody-negative disorders. The authors determined that the diagnosis of an autoimmune diseases was not associated with MGUS, but it was associated with a prior clinical diagnosis of MGUS.
The authors caution that studies based only on clinical MGUS cohorts that are very likely to have been identified through work-up of the same diseases with which an association is being sought has led to a false association.Reference:
Stages Of This Blood Cancer
Usually when a patient comes into an oncologist's office, like mine, it says 'cancer' on the door. So they know they have cancer, but they really don't know what to expect. So what you want to determine is, how serious is the multiple myeloma? How extensive is it? How is it affecting other organs?There's a big spectrum with multiple myeloma and all these plasma cell problems, from something that we call monoclonal gammopathy of unclear significance, or MGUS, where you have just a few abnormal plasma cells making an abnormal antibody, all the way to a very aggressive myeloma that can be life-threatening.
Most cancers are staged from I, II, III, and IV, and it's very cut and dry. Stage I is a small tumor. Stage II is maybe a bigger tumor in the lymph nodes. Stage III means the cancer has spread into the lymph nodes or it's a more aggressive tumor. And stage IV means it's spread throughout the whole body. Multiple myeloma staging is completely different, because from the beginning, those plasma cells are basically in all the bones for most people, so it's already spread.
There is a staging system for myeloma that can classify between I, II, and III. For most people with myeloma, if they have a stage I myeloma, then that is going to be a lower-risk cancer they're going to be able to live with for a very long time. On the opposite end, for patients with a stage III myeloma, that's going to be a very aggressive cancer that's going to need very aggressive treatment if they're going to be able to get in remission and have a long time with a good quality of life.
A stage I multiple myeloma can often be treated simply with maybe one or two medications. A stage II is going to need combination of medications to treat, and you definitely want to be a little bit more aggressive about getting it under control and getting into remission and maybe moving towards a stem cell transplant. A stage III myeloma is -- that's a patient who's going to need a whole lot of supportive care, more aggressive chemotherapy to get into remission, and more likely to have all these other organ problems like fractures or kidney failure or need blood transfusions, or all the problems that a cancer can cause.
When I talk to my patients about multiple myeloma, I don't talk about stage at all. And most oncologists in practice don't talk about it because it really isn't very helpful for making decisions. What we do talk about is, we discuss how aggressive is your multiple myeloma in your case and in your situation. Because it also has to do with a patient's overall health. So you have to put the overall amount, the aggressiveness of the cancer, in the context of that individual person.
When I meet a patient with multiple myeloma, every one of them is in a different situation. So the conversation is completely different depending on the patient situation and all the other factors. So that determinant of the biology of what's really going on in the cancer cells and how sick is it making you, that kind of sets the course for how you're going to move forward and what to expect. ","publisher":"WebMD Video"} ]]>
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Boone Goodgame, MD
Usually when a patient comes into an oncologist's office, like mine, it says "cancer" on the door. So they know they have cancer, but they really don't know what to expect. So what you want to determine is, how serious is the multiple myeloma? How extensive is it? How is it affecting other organs?There's a big spectrum with multiple myeloma and all these plasma cell problems, from something that we call monoclonal gammopathy of unclear significance, or MGUS, where you have just a few abnormal plasma cells making an abnormal antibody, all the way to a very aggressive myeloma that can be life-threatening.
Most cancers are staged from I, II, III, and IV, and it's very cut and dry. Stage I is a small tumor. Stage II is maybe a bigger tumor in the lymph nodes. Stage III means the cancer has spread into the lymph nodes or it's a more aggressive tumor. And stage IV means it's spread throughout the whole body. Multiple myeloma staging is completely different, because from the beginning, those plasma cells are basically in all the bones for most people, so it's already spread.
There is a staging system for myeloma that can classify between I, II, and III. For most people with myeloma, if they have a stage I myeloma, then that is going to be a lower-risk cancer they're going to be able to live with for a very long time. On the opposite end, for patients with a stage III myeloma, that's going to be a very aggressive cancer that's going to need very aggressive treatment if they're going to be able to get in remission and have a long time with a good quality of life.
A stage I multiple myeloma can often be treated simply with maybe one or two medications. A stage II is going to need combination of medications to treat, and you definitely want to be a little bit more aggressive about getting it under control and getting into remission and maybe moving towards a stem cell transplant. A stage III myeloma is -- that's a patient who's going to need a whole lot of supportive care, more aggressive chemotherapy to get into remission, and more likely to have all these other organ problems like fractures or kidney failure or need blood transfusions, or all the problems that a cancer can cause.
When I talk to my patients about multiple myeloma, I don't talk about stage at all. And most oncologists in practice don't talk about it because it really isn't very helpful for making decisions. What we do talk about is, we discuss how aggressive is your multiple myeloma in your case and in your situation. Because it also has to do with a patient's overall health. So you have to put the overall amount, the aggressiveness of the cancer, in the context of that individual person.
When I meet a patient with multiple myeloma, every one of them is in a different situation. So the conversation is completely different depending on the patient situation and all the other factors. So that determinant of the biology of what's really going on in the cancer cells and how sick is it making you, that kind of sets the course for how you're going to move forward and what to expect.
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