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  • Title: Does my patient with a serum monoclonal spike have multiple myeloma?
    Author: Bianchi G, Ghobrial IM.
    Journal: Hematol Oncol Clin North Am; 2012 Apr; 26(2):383-93, ix. PubMed ID: 22463833.
    Abstract:
    A monoclonal spike on serum protein electrophoresis is a frequent finding in the general population and pathognomonic of a plasma cell dyscrasia. In otherwise healthy individuals, it is diagnostic of two asymptomatic, premalignant conditions called monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) which carry a lifelong risk of progression to multiple myeloma (MM) or related malignancy. This article discusses the criteria for diagnosis of MGUS, SMM, and MM; current recommendations for follow-up and risk factors for progression to MM of patients with MGUS and SMM; and diagnostic evaluation of suspected MM transformation.
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