Winship Cancer Institute, Emory University, Atlanta, Georgia.
University of Wisconsin Carbone Cancer Center, Madison, Wisconsin.
J Natl Compr Canc Netw. 2020 Dec 1;18(12):1720-1729. doi: 10.6004/jnccn.2020.7660.
The presence of monoclonal proteins is common, with a prevalence in the United States around 5% that increases with age. Although most patients are asymptomatic, most cases are caused by a clonal plasma cell disorder. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) are asymptomatic precursor conditions with variable risk of progression to multiple myeloma. In recent years, significant progress has been made to better understand the factors that lead to the development of symptoms and progression to myeloma. This review summarizes the current diagnosis treatment guidelines for MGUS and SMM and highlights recent advances that underscore a shifting paradigm in the evaluation and management of plasma cell precursor conditions.
单克隆蛋白的存在很常见，在美国的流行率约为 5%，且随年龄增长而增加。虽然大多数患者无症状，但大多数病例是由克隆性浆细胞疾病引起的。意义未明的单克隆丙种球蛋白血症（MGUS）和冒烟型多发性骨髓瘤（SMM）是无症状的前驱状态，进展为多发性骨髓瘤的风险存在差异。近年来，人们在更好地了解导致症状发展和进展为骨髓瘤的因素方面取得了重大进展。本综述总结了目前 MGUS 和 SMM 的诊断治疗指南，并强调了最近的进展，这些进展突显了浆细胞前体疾病评估和管理观念的转变。
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