意义未明的单克隆免疫球蛋白血症的病程演变、鉴别诊断及其干预策略:第54届美国血液学会年会报道

 【摘要】　意义未明的单克隆免疫球蛋白血症（monoclonal gammopathy of undetermined significances，MGUS）被界定为癌前克隆性疾病。其在50岁以上人群中的发病率达到4.2 %，且以每年1 %的高风险向多发性骨髓瘤（multiple myeloma，MM）和相关的恶性疾病转化。确定其病程演变将指导临床诊断和治疗。大多数MGUS患者仅需随访观察。而少部分患者则经过冒烟型骨髓瘤（smoldering multiple myeloma，SMM）阶段进展为MM，或者因M蛋白导致终末器官损害，发展为轻链型疾病，如轻链型淀粉样变性、轻链沉淀病等，需要启动药物干预措施。2012年第54届美国血液学会（ASH）年会进行了这部分内容的详细报道。

Evolution, differential diagnosis and intervention strategies of monoclonal gammopathy of undetermined significances:reports in the 54 ASH annual meeting

【Abstract】　Monoclonal gammopathy of undetermined significances (MGUS) is a premalignant clonal disorder occurring in 4.2 % of adults >50 years old, and is associated with a 1 % risk every year of progression to multiple myeloma (MM), light-chain amyloidosis and related conditions. Differential diagnosis of asymptomatic and symptomatic monoclonal gammopathies is the determinant for starting therapy. Most patients with MGUS need frequent assessment and follow-up. A few patients with MGUS might progress into smoldering MM and symptomatic MM, or develop into light chain diseases such as AL amyloidosis and light chain deposition disease caused by M-protein, who should be followed with effective therapy. The above were in detail reviewed in the 54th American Society of Hematology (ASH) annual meeting.