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Sydney 2005:
The Evolving vs Non-Evolving Nature of Asymptomatic Monoclonal Gammopathies
By Joan Blade, MD
Dr. Blade supported Dr. Kyle’s presentation with his discussion on the evolving versus non-evolving nature of asymptomatic monoclonal gammopathies. Monoclonal gammopathy of undetermined significance (MGUS) indicates a serum M-protein of less than 30 g/dL and less than 10% bone marrow plasma cells (BMPC). Dr. Blade commented that evolving SMM showed a progressive increase in M-protein size until symptomatic MM developed. Whereas, non-evolving SMM characterized a stable M-protein until symptomatic disease developed. In studies, the median time to progression to symptomatic MM was 3 years. However, the evolving SMM had a shorter median time to progression of 1.5 years. Studies also showed that evolving SMM has a pattern of genetic abnormalities and chromosomal losses, whereas chromosomal losses were less common in non-evolving SMM. Dr. Blade’s preliminary analysis suggests that MGUS is a predictor of malignant transformation probability.

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