Approaching Hypercalcemia in Monoclonal Gammopathy of Undetermined Significance: Insights from the iStopMM study.

Autor:	Jónsdóttir ÁH; University of Iceland, Reykjavi-k, Iceland., Sigurjónsdóttir HÁ Prof; University of Iceland, Iceland., Thorsteinsdottir S; University of Iceland., Einarsson Long T; University of Iceland, Iceland., Sverrisdóttir IS; University of IcelandLandspitali - The National University Hospital of Iceland, Reykjavik, Iceland., Eythorsson E; University of Iceland, Iceland., Oskarsson JT; University of Iceland, Reykjavik, Iceland., Pálsson R; Landspitali University Hospital, Reykjavik, Iceland., Indridason OS; University of Iceland, Iceland., Vidarsson B; Landspítali-The National University Hospital of Iceland, Iceland., Onundarson PT; Landspitali National University Hospital, Reykjavik, Iceland., Olafsson I; Landspitali University Hospital and University of Iceland Faculty of Medicine, Reykjavik, Iceland., Þorsteinsdóttir I; -The National University Hospital of Iceland, Reykjavik, Iceland, Reykjavik, Iceland., Agnarsson BA; University of Iceland, Iceland., Sigurdardottir M; Landspítali-The National University Hospital of Iceland, Reykjavik, Iceland., Jonsson A; Akureyri Hospital, Iceland., Hultcrantz ML; Memorial Sloan Kettering Cancer Center, New York, New York, United States., Durie BGM; Cedars-Sinai Outpatient Cancer Center, Los Angeles, California, United States., Harding S; The Binding Site Ltd., Birmingham, United Kingdom., Landgren CO; Division of Myeloma, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida, United States., Love TJ; Akureyri Hospital, Iceland., Kristinsson SY; University of Iceland, Reykjavik, Iceland., Rögnvaldsson S; University of Iceland, Reykjavík, Iceland.
Jazyk:	angličtina
Zdroj:	Blood [Blood] 2024 Dec 19. Date of Electronic Publication: 2024 Dec 19.
DOI:	10.1182/blood.2024025624
Abstrakt:	Hypercalcemia in monoclonal gammopathy of undetermined significance (MGUS) presents a clinical challenge since it may indicate progression to multiple myeloma (MM) but could also be due to a multitude of unrelated disorders. To inform the approach to this clinical challenge, we conducted a nested cohort study within the iStopMM screening study. Of the 75,422 Icelanders aged 40 years and above who underwent screening for MGUS, we included 2,546 with MGUS who were in active follow-up, including regular serum calcium measurements. In total, 191 individuals (7.5%) had hypercalcemia detected at least once, of whom 93 had persistent hypercalcemia (48.7%). MM was found in 3 participants with persistent hypercalcemia (3.2%); all had concurrent bone disease and other end-organ damage. The most common causes of hypercalcemia were primary hyperparathyroidism (56.0%) and malignancies other than MM (16.0%). In this first comprehensive study on hypercalcemia in MGUS, we observed that hypercalcemia rarely indicated MGUS progression and never in the absence of other symptoms of MM. More than half of hypercalcemia cases were transient and the underlying causes were similar to those in the general population. We conclude that hypercalcemia in MGUS should be approached in the same way as in those without MGUS. (Copyright © 2024 American Society of Hematology.)
Databáze:	MEDLINE
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