From Myeloma Precursor Disease to Multiple Myeloma: New Diagnostic Concepts and Opportunities for Early Intervention

摘要: Since monoclonal gammopathy of undetermined significance (MGUS) was first described more than 30 years ago, the definition entity has evolved. Today, 3 distinct clinical MGUS subtypes have been defined: non-immunoglobulin M (IgM; IgG or IgA) MGUS, IgM and light chain MGUS. Each subtype is characterized by unique intermediate stages progression events. Although we now strong evidence that multiple myeloma consistently preceded a precursor state at molecular level, there urgent need to better understand mechanisms regulate transformation from full-blown myeloma. In future, if such knowledge available, it would allow clinicians define high-risk low-risk patients for tailored management. Also, provide insights on individual patient's disease biology, which, in turn, can be used targeted individualized treatment strategies. On basis current guidelines, diagnosed with smoldering should not treated outside trials. near seems reasonable believe will likely become candidates early this review, discuss novel recent studies propose future directions relevance management research studies.