open access

Vol 52, No 4 (2021)
Review article
Published online: 2021-08-31
Submitted: 2021-05-08
Accepted: 2021-05-12
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Monoclonal gammopathy of clinical significance (MGCS): when monoclonal gammopathy of undetermined significance (MGUS) is no longer undetermined

Lidia Usnarska-Zubkiewicz1
DOI: 10.5603/AHP.2021.0072
·
Acta Haematol Pol 2021;52(4):382-389.
Affiliations
  1. Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland

open access

Vol 52, No 4 (2021)
REVIEW ARTICLE
Published online: 2021-08-31
Submitted: 2021-05-08
Accepted: 2021-05-12

Abstract

Monoclonal gammopathy of undetermined significance (MGUS) is a condition characterized by the presence of a monoclonal immunoglobulin (mIg) without its organ- or tissue-damaging effect. In recent years, attention has been paid to patients who show a MGUS-like condition, but at the same time present damage to the kidneys, peripheral nerves, or skin, resulting from the deposit of mIg. These disorders do not meet the criteria for smoldering myeloma or multiple myeloma. In 2018, the term ‘monoclonal gammopathy of clinical significance’ (MGCS) was introduced for this group of patients.

The dysfunction associated with MGCS is the result of the toxic activity of a monoclonal protein produced by dangerous, small clones of B cells and plasmocytes. Taking this into account, the term ‘MGUS’ should be limited to those cases where no association with mIg organ or tissue damage can be demonstrated, whereas the term ‘MGCS’ (monoclonal gammopathy of clinical significance) should be used in patients in whom the monoclonal protein plays a direct role in damage, especially to the kidneys, skin, and nervous system. This article summarizes the current state of knowledge of the main syndromes and symptoms of MGCS.

Abstract

Monoclonal gammopathy of undetermined significance (MGUS) is a condition characterized by the presence of a monoclonal immunoglobulin (mIg) without its organ- or tissue-damaging effect. In recent years, attention has been paid to patients who show a MGUS-like condition, but at the same time present damage to the kidneys, peripheral nerves, or skin, resulting from the deposit of mIg. These disorders do not meet the criteria for smoldering myeloma or multiple myeloma. In 2018, the term ‘monoclonal gammopathy of clinical significance’ (MGCS) was introduced for this group of patients.

The dysfunction associated with MGCS is the result of the toxic activity of a monoclonal protein produced by dangerous, small clones of B cells and plasmocytes. Taking this into account, the term ‘MGUS’ should be limited to those cases where no association with mIg organ or tissue damage can be demonstrated, whereas the term ‘MGCS’ (monoclonal gammopathy of clinical significance) should be used in patients in whom the monoclonal protein plays a direct role in damage, especially to the kidneys, skin, and nervous system. This article summarizes the current state of knowledge of the main syndromes and symptoms of MGCS.

Get Citation

Keywords

monoclonal gammopathy of undetermined significance (MGUS), monoclonal gammopathy of clinical significance (MGCS), monoclonal gammopathy of renal significance (MGRS), neurological MGCS, cutaneous MGCS

About this article
Title

Monoclonal gammopathy of clinical significance (MGCS): when monoclonal gammopathy of undetermined significance (MGUS) is no longer undetermined

Journal

Acta Haematologica Polonica

Issue

Vol 52, No 4 (2021)

Article type

Review article

Pages

382-389

Published online

2021-08-31

DOI

10.5603/AHP.2021.0072

Bibliographic record

Acta Haematol Pol 2021;52(4):382-389.

Keywords

monoclonal gammopathy of undetermined significance (MGUS)
monoclonal gammopathy of clinical significance (MGCS)
monoclonal gammopathy of renal significance (MGRS)
neurological MGCS
cutaneous MGCS

Authors

Lidia Usnarska-Zubkiewicz

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