Reviewed By: Pramod Kerkar, MD, FFARCSI

Prognosis of monoclonal gammopathy of undetermined significance depends upon the progression of the disease in its severe form. If the disease remains stable and results in general complications such as neuropathy, or skeletal complications, the prognosis is favorable.

Prognosis For MGUS Or Monoclonal Gammopathy Of Undetermined Significance

Monoclonal Gammopathy of Undetermined Significance is the condition characterized by the presence of an abnormal protein, called as M protein or myeloma protein in the blood. The prognosis of the disease depends upon the variety of factors including the stability of the disease and the associated complications.

Further, the prognosis of the disease also depends upon the regular checking and monitoring of the disease and the blood protein levels of the patients. The disease has the chances of progression into multiple myeloma or other lymphoproliferative disorder such as lymphoma, leukemia or amyloidosis. The progression may be slow and transforms into complications in many years or there is an acute conversion of monoclonal gammopathy of undetermined significance to myeloma or lymphoma.

Patients who have stable form of disease have favorable prognosis as compared to patients whose disease is progressive. As the symptoms of the disease are rare, the patient does not have any problem in the stable form of the disease.

Various studies have conducted to establish the prognosis of MGUS and it has been estimated that the disease has a conversion rate of approximately 1-2% in its more lethal progressive form. Many of the patients, who were enrolled in the study, have died due to another reason due to their age. The level of monoclonal protein is also a subject of debate in the transformation of the disease.

Some studies suggested that there is no correlation between the level of this protein and disease progression while some suggest that high level or progressive increase in the level of monoclonal protein is a factor for conversion to myeloma. Studies also indicate that other factors that suggest the transformation of disease are level of uninvolved Ig, IgA and labeling index of plasma cells.

Age is also a factor in the prognosis of the disease as elderly and geriatric patients are at increased risk of progression to lymphoproliferative disorders as compared to people with lesser age.

Complications Of Monoclonal Gammopathy Of Undetermined Significance or MGUS

Monoclonal Gammopathy of Undetermined Significance rarely shows any symptom, but the disease can be progressed into a much severe form including various lymphoproliferative disorders. Thus, regular checking and monitoring of the blood level of monoclonal protein and other immunoglobins, both involved and uninvolved are required to diagnose the disease at an early stage.

Following are the diseases that may develop due to the progression of Monoclonal Gammopathy of Undetermined Significance:

Multiple Myeloma. MGUS may progress into multiple myeloma and the rate of transformation is approximately 1% per year. The rate of progression is even higher in patients suffering from high-risk monoclonal gammopathy of undetermined significance. High-risk MGUS is characterized by the presence of M-protein more than 1.5 gm/dl, type of M-protein other than IgG, and an abnormal free light chain ratio.

Chronic Lymphocytic Leukemia. Patients with monoclonal gammopathy of undetermined significance are at higher risk of developing leukemia.

B-cell Lymphoma. The patients of lymphoma are diagnosed by the presence of lymphadenopathy, and an extranodal tumor in lymph tissues during initial examination. These findings are confirmed through biopsy.

Waldenström's Macroglobulinemia. Patient’s with MGUS are at increased risk of developing Waldenström's macroglobulinemia. This condition is characterized by the presence of a high level of serum IgM and an increase in lymphocytes of one narrow. A study indicates that almost 7% of the patients suffering from monoclonal gammopathy of undetermined significance have developed this condition.

Peripheral Neuropathy. Patient with monoclonal gammopathy of undetermined significance presents various neurological symptoms such as numbness, tingling sensation, burning feet and neuropathic pain.

Skeletal Complications. Patients of MGUS have a higher risk of developing osteoporosis.

Infections. Due to reduced formation of normal immunoglobulins, the patients of MGUS have a higher risk of infections.

Conclusion

Prognosis of monoclonal gammopathy of undetermined significance is poor when the disease progresses in lymphoproliferative disorders. These, sometimes fatal, the condition includes multiple myeloma, leukemia, amyloidosis, and Waldenström's macroglobulinemia.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: February 14, 2019

This article does not provide medical advice. See disclaimer

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