Abstract

ALEJANDRE, Mariel Emilce et al. Monoclonal gammopathy of undetermined significance: prognostic factor and risk of progression. Acta bioquím. clín. latinoam. [online]. 2013, vol.47, n.1, pp.71-84. ISSN 0325-2957.

Monoclonal gammopathy of undetermined significance (MGUS) is considered a premalignant state with a stable clinical course, and increased prevalence/risk of developing multiple myeloma (MM) or related malignancy according to age. To evaluate some hematologycal and protein parameters of prognostic value, 407 patients diagnosed as MGUS had been analyzed between 1982 to 2008 by means of complete urine and serum profile. A densitometry spike value (>1.5 g/dL), the monoclonal immunoglobulin class (No-IgG), the reduced concentration of non related immunoglobulin’s, the percentage of plasma cells in bone marrow (>5%) and an abnormal serum kappa/lambda free ratio; marked the increased risk of malignant progression. In urine, the presence of low molecular weight proteins has been associated with eGFR < 60 mL/min/1.73 m2 and the confirmation of Bence Jones proteinuria, independently of light chain type and the proteinuria level, reflecting a tubular damage. With an in deep view, a urine protein profile should detect an early renal compromise. We concluded that laboratory controls in patients with MGUS should be adjusted by periodicity but not in its content. A clear medical decision for the controls frequency or for establishing a worse outcome should be based on a complete protein profile evaluation.

Keywords : Monoclonal gammopathy of undetermined significance; Evolution risk; Kappa lambda ratio; Protein profile.

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