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The significance of free light-chain ratio in light-chain monoclonal gammopathy of undetermined significance: a flow cytometry sub-study of the iStopMM screening study.
Blood Cancer J
December 2024
Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
Light-chain (LC) monoclonal gammopathy of undetermined significance (MGUS) is a precursor of multiple myeloma (MM) and related conditions. LC-MGUS is characterized by free light-chain (FLC) levels outside defined reference intervals, indirectly indicating underlying plasma cell (PC) monoclonality. Next-generation flow cytometry (NGF) was used to evaluate clonal PC presence in bone marrow (BM) samples from individuals with LC-MGUS in the iStopMM study, aiming to assess the predictive value of the FLC ratio for clonal PC presence and its prognostic implications.
View Article and Find Full Text PDFRenal manifestations of MGUS.
Hematology Am Soc Hematol Educ Program
December 2024
Department of Hematology and Cellular Therapy, Centre de référence maladies rares, Amylose AL et autres maladies par dépôts d'immunoglobulines monoclonales, Centre Hospitalier Universitaire Limoges, Université de Limoges, Limoges, France.
Kidney disease is a common complication of monoclonal immunoglobulin (MIg)-secreting B-cell disorders and predominantly occurs in patients who do not meet the criteria for an overt hematological disease. To distinguish this situation from monoclonal gammopathy of undetermined significance, which lacks organ damage, the term monoclonal gammopathy of renal significance (MGRS) was introduced to depict the association of a small, otherwise indolent B-cell clone, with renal disease induced by the secreted MIg. The spectrum of renal disorders in MGRS is wide, encompassing both tubular and glomerular disorders, classified according to the composition of deposits and their ultrastructural pattern of organization.
View Article and Find Full Text PDFFeasibility of a Biomarker-Based Screening for Pre-Symptomatic AL Amyloidosis in Patients With Intermediate/High-Risk MGUS.
Am J Hematol
February 2025
Department of Molecular Medicine, University of Pavia, Italy.
Biomarker-based screening enables early detection of AL amyloidosis in intermediate/high-risk MGUS patients. Our study shows that identifying pre-symptomatic AL through biomarker longitudinal monitoring allows early treatment, leading to significant organ function recovery.
View Article and Find Full Text PDFRare case of wtTTR amyloidosis and MGUS in a patient with lung adenocarcinoma.
BMJ Case Rep
December 2024
Hematology Oncology, Cleveland Clinic, Cleveland, Ohio, USA
Amyloidosis is a rare, multisystem disease that leads to deposition of misfolded proteins in various organs. This case report presents a patient with cancer with a rare diagnosis of diffuse alveolar-septal transthyretin (TTR) amyloidosis with subsequent protein electrophoresis identifying monoclonal gammopathy of unknown significance. It highlights the association of amyloidosis with malignancy and the importance of including workup for plasma cell dyscrasias in patients found to have TTR amyloidosis.
View Article and Find Full Text PDFSerum free light chains in a racially diverse population including African Americans and populations from South Africa.
Blood
November 2024
Dana-Farber Cancer Institute, Boston, Massachusetts, United States.
Detection of light chain (LC) monoclonal gammopathies (MG) traditionally relies on serum free LC (FLC) κ, λ, and their ratio (κ/λ) reference ranges based on a mostly White population. We investigated FLC values in a racially diverse population by screening 10,035 individuals for heavy chain MG, identifying 9,028 negative cases whose FLC were measured. Participants included 4,149 from the PROMISE Study (US, n=2,383; South Africa, n=1,766) and 4,879 from the Mass General Brigham Biobank, with 44% self-identifying as Black.
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