- MGUS monoklonale Gammopathie unklarer Signifikanz
- SMM smoldering multiple Myeloma
(asyptomatisches Myelom)
MGUS
monoklonale Gammopathie unklarer Signifikanz
Konsequenz:
- keine Therapie
- Verlaufskontrolle alle 6-12 Monate
low-risk
MGUS (50% of all MGUS cases) by the Mayo Clinic criteria:
- (IgG M-protein <1.5 g/dL with normal FLC ratio) in the absence of concerning symptoms such as anemia or poor renal function
- no further initial evaluation is needed (= keine Biopsie).
Definition:
International Myeloma Working Group criteria:
- Serum M protein <3 g/dL
- Light-chain restricted bone marrow plasma cells <10%
- No end-organ damage
- Serumelektrophorese
- Knochenmarkbiopsie
- Niere,Elo,Blutbild, Skelett-Rö, MR Wirbelsäule-Becken
Mayo Clinic Faktoren:
- non-IgG isotype
- serum
M-protein concentration
> 1.5 g/dL - FLC-ratio aus der Norm
absolute risk of progression for MGUS:
- Risikofaktoren = 0
5% Progressionsrisiko = low risk MGUS
Observans:
6 months and, if stable, every 2-3 years
- although lytic bone lesions are not seen in MGUS,
the RANKL/osteoprotegerin ratio is higher inMGUS subjects, and
they are at a higher risk of fractures than healthy controls
- Zometatherapie alle 3-6 Monate empfohlen
(für 2 Jahre anschl. Evaluation)
- siehe auch Therapie der Osteolysen
- siehe auch high risk MGUS
- Zometatherapie alle 3-6 Monate empfohlen