Multiple Myeloma

MGUS and the Development of Myeloma

Multiple myeloma often begins as a harmless condition known as monoclonal gammopathy of undetermined significance (MGUS). People with MGUS have an abnormal protein antibody known as a monoclonal immunoglobulin (M protein). The presence of the M protein indicates a small amount of abnormal plasma cells in the bone marrow. However, these abnormal cells do not form tumors or cell masses, and people with MGUS do not have any other signs of myeloma, such as low red blood cell counts or bone damage.

People with MGUS have a 1-percent per year chance of progressing to multiple myeloma or lymphoma (see page 16 for a description of lymphoma). The higher the number of abnormal plasma cells in the bone marrow and the higher the level of the M protein, the higher the chances that MGUS will progress to multiple myeloma or lymphoma. Researchers have been studying the genes of abnormal plasma cells in MGUS patients and have found that they’re more like myeloma cells than normal plasma cells. This finding suggests that they may indeed be cancerous.

In addition to multiple myeloma or lymphoma, people with MGUS may develop a form of myeloma with few symptoms, known as indolent (or smoldering) myeloma. People diagnosed with this type of myeloma have a higher level of the M protein in their blood and more abnormal plasma cells in their bone marrow than those with MGUS. Despite this, they still do not have any other signs or symptoms of multiple myeloma. Most people with smoldering myeloma will eventually develop multiple myeloma.

 

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