Do patients with MGUS always need to undergo a bone marrow test? (https://www.myeloma.org/videos/do-patients-mgus-always-need-undergo-bone-marrow-test)
Does MGUS Require Bone Marrow Testing?
A new study from Iceland, part of the IMF's iStopMM project, distinguishes between patients who require bone marrow testing and those who can be safely monitored without immediate bone marrow testing.
The study accurately predicted that patients with a bone marrow percentage of less than 10% would fall into the MGUS category, avoiding the need for bone marrow testing. The findings of this study offer a significant advancement, potentially saving patients from invasive bone marrow tests, reducing costs, and benefiting the healthcare system overall.
The BOTTOM LINE: In 2024, advancements in blood testing provide a safe alternative to bone marrow testing for patients with MGUS, offering a more convenient and cost-effective monitoring approach.
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This week's "Ask Dr. Durie" comes from a patient with MGUS; monoclonal gammopathy of undetermined significance. And the question is, do I need to have a bone marrow test? And this is obviously a very, very good question because when you have this low level of disease, it's important to know is it at a level where maybe is progressing into smoldering myeloma or maybe even early active myeloma?
And so, if a bone marrow is needed to get that answer, then it needs to be done. Well, in this situation, we have a new study from Iceland, part of the IMF supported iStopMM project, which helps to give advice in this setting. And so, what the iStopMM team did is they looked at simple blood testing to see if that would give an indication if the bone marrow percentage would be above 10% which would mean that the patient actually has smoldering myeloma or is moving towards active myeloma.
And so, they just took some simple blood tests looking at the type of the myeloma, the level of the free light test, the level of the myeloma protein level and also the level of the normal immunoglobulins IgG, IgA and IgM.
So using these simple blood tests, they were able to predict very accurately that a patient, if a bone marrow test was performed, their percentage would be less than 10%, and so they would fall solidly into that MGUS category. And so, this means that just using these simple blood tests, a bone marrow testing can be avoided, which is great for the patient is great, and reducing the costs and just generally good for the whole health care system.
And so, we're very pleased that this study has just been completed and the results, are being published April 1st, 2024, in the journal Annals of Internal Medicine. And so I think that this is an important step forward. and so BOTTOM LINE, here in 2024, there is now a possibility to safely avoid that dreaded bone marrow test and continue to monitor with regular testing.
Dr. Brian G.M. Durie (1942-2025) was the co-founder of the IMF. He was a Professor of Medicine, Hematologist/Oncologist, and Honoree MD at the University of Brussels.