There is a new research paper that looks at people with smoldering multiple myeloma or MGUS who have two or more M-spikes. I mentioned it because the topic sometimes comes up here in the forum.
The paper is by researchers at the Mayo Clinic. It concludes that having one or more additional M-spikes, beyond the usual single M-spike, does not seem to affect either how fast the patient's MGUS / smoldering myeloma progresses to symptomatic multiple myeloma, or how the symptomatic multiple myeloma responds to treatment.
Here is the reference and article abstract:
TC Mullikin et al, "Clinical characteristics and outcomes in biclonal gammopathies", American Journal of Hematology, February 2016 (abstract)
Abstract:
A single monoclonal protein typically characterizes monoclonal gammopathies, but a small proportion may have more than one M protein identifiable. In the setting of symptomatic multiple myeloma, the development of a new monoclonal protein following therapy is associated with better outcomes. As for the precursor conditions, MGUS and SMM, there is limited information on the impact of a second monoclonal protein on the disease course, including progression and response to treatment. We report outcomes of patients with MGUS and SMM with more than one monoclonal protein, after identifying 539 patients with biclonal proteins on electrophoresis and/or immunofixation. Twenty-two of 393 patients with MGUS/BGUS progressed to SMM (6), multiple myeloma (11), AL (3), or WM (2), and 5 of 16 patients with biclonal SMM progressed to multiple myeloma. The rate of progression for BGUS was approximately 1% per year, which is similar to MGUS with one monoclonal protein. The median estimated time of progression of biclonal SMM was 2.6 years; similar to monoclonal SMM. For patients with biclonal multiple myeloma, both M spikes responded to treatment and, upon relapse, the original dominant M protein remained dominant as the disease progressed. In conclusion, the presence of a second monoclonal protein does not appear to affect the progression of precursor states and suggests multiple monoclonal proteins do not clinically impact one another in the course of the disease.
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Re: Biclonal smoldering multiple myeloma & MGUS
Thank you, Cheryl, for that info. I have had double M-spikes a couple years now. Glad to know it's nothing to worry about.
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