Malignant transformation in MGUS

Eurelings M et al. Maligannt transformation in polyneuropathy associated with monoclonal gammopathy. Neurology 2005; 64:2079-2084.
Of 193 patients with MGUS and polyneuropathy, 17 had a hematologic diagnosis at onset. The rate of transformation in the remaining patients was 2.7 % per year. Independent predicting factors associated with transformation were progressive neuropathy, weight loss, fevers, night sweats and Mm-protein level.
Notes: diagnotic criteria for MGUS include M proteinlevel< 30 g/dl, bm plasma cell infiltrate of less than 10 %, absent lytic lesions in bone, anemia, hypercalcemia, renal insufficiency, and stable M protein level, as well as absent fatigue, weight loss, bone pain or susceptibility to infections. There was no effect of IgG v IgA or kappa v lambda