Rizikové monoklonální gamapatie nejasného významu -- léčit nebo neléčit?

Monoclonal gammopathy of undetermined significance (MGUS) is defined as a clinically silent, symptom-free state that does not meet the diagnostic criteria of multiple myeloma (MM), Waldenstrom macroglobulinemia, AL-amyloidosis or any other malignant lymphoproliferative disease. Long-term follow-up has demonstrated that this may be a pre-cancerous state with transformation into a malignant monoclonal gammopathy in approximately 1% of cases annually. Probably all cases of MM arise as a transformation of MGUS. In this overview, the author attempts to answer the key question, namely whether it is currently possible in some way to prevent the transformation of MGUS into MM or to at least to slow this down. The answer in MGUS patients is currently unequivocally NO. In view of the significantly higher risk of transformation in patients with asymptomatic multiple myeloma than in patients with MGUS, further analysis by the CMG will focus on this group of patients with the goal of selecting the group at highest risk and to subject this group to early and if possible nontoxictreatment. [ABSTRACT FROM AUTHOR]