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lüll Management of paraproteinaemia Cook L; Macdonald DHPostgrad Med J 2007[Apr]; 83 (978): 217-23A paraprotein is a monoclonal immunoglobulin or light chain present in the blood or urine; it is produced by a clonal population of mature B cells, most commonly plasma cells. In individuals aged >50 years the incidence of a paraprotein is 3.2%. Plasma cell disorders can be considered as a spectrum of conditions ranging from monoclonal gammopathy of undetermined significance (MGUS), through asymptomatic, to symptomatic myeloma. MGUS is defined by a low level of paraprotein <30 g/l, bone marrow plasma cells <10% and the absence of myeloma related organ or tissue damage (predominantly renal, skeletal or bone marrow impairment.) MGUS requires no therapy and the overall risk of progression to myeloma is 1% per year. Myeloma remains incurable with a median survival of 3-4 years; autologous stem cell transplant can prolong survival, if appropriate. Thalidomide in combination with dexamethasone has an emerging role in the treatment of myeloma.|Anemia/etiology[MESH]|Diagnosis, Differential[MESH]|Diphosphonates/therapeutic use[MESH]|Humans[MESH]|Hypercalcemia/therapy[MESH]|Infections/etiology[MESH]|Kidney Diseases/etiology[MESH]|Multiple Myeloma/diagnosis[MESH]|Pain/prevention & control[MESH]|Paraproteinemias/diagnosis/etiology/*therapy[MESH]|Prognosis[MESH]|Referral and Consultation[MESH] |