Clinical disorders associated with MGUS
| Clinical disorders . | Treatment . |
|---|---|
| Monoclonal gammopathies of renal significance | Reference116 |
| Immunoglobulin light-chain amylodosis (AL) | Stage 1 and II disease: melphalan + dexamethasone If stage III or severe renal dysfunction: cyclophosphamide/bortezomib/dexamethasone |
| Immunoglobulin heavy-chain amyloidosis (AH) | |
| Immunoglobulin light and heavy chain (ALH) | |
| Type 1 cryoglobulinemia | If plasmacytic IgG or IgA: antimyeloma regimens If lymphoplasmacytic IgM: rituximab containing regimen |
| Type 2 cryoglobulinemia | Rituximab-containing regimen Treat underlying hepatitis C |
| Immunotactoid glomerulonephropathy (ITG) | Cyclophosphamide/bortezomib/dexamethasone |
| Monoclonal immunoglobulin deposition disease (MIDD) | Cyclophosphamide/bortezomib/dexamethasone Successful use of autologous stem cell transplant reported |
| Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) | Cyclophosphamide/bortezomib/dexamethasone |
| Fanconi syndrome (FS) | Cyclophosphamide/bortezomib/dexamethasone |
| Paraproteinemic neuropathy | Reference114 |
| Distal demyelinating symmetric neuropathy with IgM (DADS-M) | IVIG, consider rituximab |
| IgG/A axonal neuropathy | Plasmapheresis, IVIG, steroids |
| IgG/A chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) | |
| Severe and refractory neuropathy | Consider clinical trial or antimyeloma regimens Successful use of autologous stem cell transplant reported |
| Clinical disorders . | Treatment . |
|---|---|
| Monoclonal gammopathies of renal significance | Reference116 |
| Immunoglobulin light-chain amylodosis (AL) | Stage 1 and II disease: melphalan + dexamethasone If stage III or severe renal dysfunction: cyclophosphamide/bortezomib/dexamethasone |
| Immunoglobulin heavy-chain amyloidosis (AH) | |
| Immunoglobulin light and heavy chain (ALH) | |
| Type 1 cryoglobulinemia | If plasmacytic IgG or IgA: antimyeloma regimens If lymphoplasmacytic IgM: rituximab containing regimen |
| Type 2 cryoglobulinemia | Rituximab-containing regimen Treat underlying hepatitis C |
| Immunotactoid glomerulonephropathy (ITG) | Cyclophosphamide/bortezomib/dexamethasone |
| Monoclonal immunoglobulin deposition disease (MIDD) | Cyclophosphamide/bortezomib/dexamethasone Successful use of autologous stem cell transplant reported |
| Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) | Cyclophosphamide/bortezomib/dexamethasone |
| Fanconi syndrome (FS) | Cyclophosphamide/bortezomib/dexamethasone |
| Paraproteinemic neuropathy | Reference114 |
| Distal demyelinating symmetric neuropathy with IgM (DADS-M) | IVIG, consider rituximab |
| IgG/A axonal neuropathy | Plasmapheresis, IVIG, steroids |
| IgG/A chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) | |
| Severe and refractory neuropathy | Consider clinical trial or antimyeloma regimens Successful use of autologous stem cell transplant reported |