MGUS does not usually produce any signs and symptoms and hence, does not require any treatment. However, in a small number of people, monoclonal gammopathy of undetermined significance may progress to some more serious disorders like multiple myeloma. While MGUS does not go away, fortunately it does not require treatment in most cases. Watchful waiting is advised, and certain medications can help in some cases of MGUS.
What Is The Best Treatment For MGUS Or Monoclonal Gammopathy Of Undetermined Significance?
Most persons with monoclonal gammopathy of undetermined significance do not require any treatment, as MGUS does not cause any signs and symptoms and is mostly diagnosed by chance during blood tests carried out for other purposes. However, since there is a risk of MGUS progressing into severe conditions, however small the risk may be, the doctor is likely to ask you to take several tests regularly, to detect any changes in MGUS at the earliest. The regular follow up may usually start around six months after you were initially diagnosed.
The treatment may consist of-
Waiting– If you are found to be at an increased risk of getting other sever conditions, it is likely that your doctor might recommend frequent follow-ups so that any further development can be detected and treated as early as possible. Your doctor will watch for some signs and symptoms during this waiting period. He will see and ask you if there is any –
- Pain
- Weight loss that is unintended
- Weakness or fatigue
- Fever
- Night sweats
- Nerve pain
- Changes in hearing and/or vision
- Headache, vertigo, dizziness or giddiness
- Bleeding
- Any blood abnormalities like anemia or such like
- Hepatomegaly, splenomegaly or swollen lymph nodes
- Any kidney or heart related problems
If you are suffering from osteoporosis, your physician may ask you take a medication called bisphosphonate which may increase bone density. These may include alendronate, risedronate, ibandronate and zoledronic acid.
Diagnosis Of Monoclonal Gammopathy Of Undetermined Significance
MGUS is usually detected by chance when blood tests are carried out for some other purposes. The blood tests may reveal presence of some abnormal proteins and some uncommon amounts of normal proteins. However, the paraproteins may also be present in some other, more serious disorders. Hence, several blood tests may be required to rule out the possibility of such serious conditions and establish a diagnosis of monoclonal gammopathy of undetermined significance. Also, certain blood tests will be required to evaluate which type of m protein is being made by your body and how much amounts are being made. Also, several other tests may also be advised by your doctor.
The tests may include-
Blood tests-
Tests like complete blood count, serum creatinine, serum calcium tests an be done which may help to rule out serious conditions like multiple myeloma
Urine tests-
- Urine tests can reveal if abnormal proteins are being excreted in the urine
- This can also provide a guidance in assessment of any kidney damage
- You may need to collect urine for 24 hours
Scans-
- Imaging tests or scans like CT scan and MRI will be advised if your symptoms are pertaining to bone pain
- PET scanning may also be advised in some cases
- These tests will help in ascertaining any bone abnormalities
Bone marrow test-
The bone marrow is removed with the help of a hollow needle and analyzed to check on the percentage of plasma cells
Bone marrow test is usually done only when your doctor suspects you to be at a risk for developing more serious conditions or if you present with signs and symptoms like anemia of unknown origin, renal failure, bone lesions or very high levels of calcium
MGUS or monoclonal gammopathy of undetermined significance is a state in which an atypical protein called as a paraprotein or m protein or monoclonal protein, is present in blood. This protein is made in the plasma cells of the bone marrow. Plasma cells are a type of white blood cells.
- Kyle, Robert A., and S. Vincent Rajkumar. “Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple Myeloma: Emphasis on Risk Factors for Progression.” European Journal of Haematology, Volume 85, Issue 1, 2010, pp 34-39. DOI: 10.1111/j.1600-0609.2010.01441.x
- San Miguel, Jesús F., et al. “Monoclonal Gammopathy of Undetermined Significance: A Review of the Pathophysiology, Prognosis, and Management.” Hemasphere, Volume 3, Issue 2, 2019, e172. DOI: 10.1097/HS9.0000000000000172
- International Myeloma Working Group. “Criteria for the Classification of Monoclonal Gammopathies, Multiple Myeloma and Related Disorders: A Report of the International Myeloma Working Group.” British Journal of Haematology, Volume 121, Issue 5, 2003, pp 749-757. DOI: 10.1046/j.1365-2141.2003.04355.x
- Rajkumar, S. Vincent. “Monoclonal Gammopathy of Undetermined Significance.” New England Journal of Medicine, Volume 375, Issue 8, 2016, pp 691-692. DOI: 10.1056/NEJMc1607471
- Leung, Nelson, and S. Vincent Rajkumar. “MGUS and Smoldering Multiple Myeloma: Diagnosis, Risk Stratification, and Management.” Hematology/Oncology Clinics of North America, Volume 28, Issue 5, 2014, pp 865-879. DOI: 10.1016/j.hoc.2014.06.011
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