MGUS Flashcards
MGUS types
non- IgM
IgM- 15%
Light chain
Mean age
70
increases with age
M:F ratio
2:1
Related diseases
(long list)
NHL
CLL
Conective tissue disorders
PMR
Psoriatic arthritis
HCV, HIV
Dermatologic disorders
Nephropathies
Zebras:
Acquired VWD
Acquired C1 esterase inhibitor deficiency
Cryoglobulinemia
Capillary leak syndrome
Cold agglutinin disease
Insulin autoimmune syndrome
TEMPI (telangiectasias, erythrocytosis with elevated erythropoietin, MGUS, perinephric fluid collections, and intrapulmonary shunting)
Crystal-storing histiocytosis
Gaucher disease
CRAB
Calcium > 11.5
HB < 10 g%
Cre > 2 or EGFR < 40
Lytic leisons
Reasons for BM
CRAB
M protein > 1.5 g
non IgG protein
Abnormal FLC ratio- not practical
Other workup in susp. MM
TBCT/PETCT
b2-microglubulin
CRP, LDH, Albumin
POEMS
(long criteria)
MGUS + Polyneuropathy +
1 of 3:
Castelman
Sclerotic bone leisons
VEGF
1 of 6:
Organomegaly
Endocrinopathies
Skin changes
Anasarca
Papilledema
Thrombocytosis/polycythemia
TEMPI syndrome
Telangiectasias
Erythrocytosis with elevated erythropoietin
MGUS
Perinephric fluid collections
Intrapulmonary shunting
Immunophenotype
CD38 CD138
CD45 CD19 CD27
20/2/20
Risk factors for progression of SMM to MM
> 20% BMPC
> 2 g M protein
FLC ratio > 20
Tx of high risk SMM
Watch and wait. but lenalidomide is starting to be an option
MGUS definition
BM plasma cell < 10%
Monoclonal protein < 3 g%
no CRAB
SMM definition
60% > BM plasma cell > 10%
Monoclonal protein > 3 g%
BJ > 500 mg/d
Risk factors for MGUS
Age
Male sex
African descent
Immunocompromised pts
Smoking
Occupational toxins
Family history
