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Obesity - which can be controlled through diet, exercise and proper insulin function - is associated with increased risk of MGUS. Having a family history of multiple myeloma also increases the lifetime risk of MGUS.
The use of metformin, a drug used for diabetics, is associated with reduced progression of MGUS to multiple myeloma. It delays myeloma by 4 years in patients with type 2 diabetes. Reduced risk is also associated with regular use of aspirin. Because behavior and easily accessible medicines can help delay progression, it is of interest to screen these folks with the goal of detecting MGUS early and reducing myeloma occurrences and death.
In prior studies it was found that patients who knew they had MGUS and progressed to myeloma had 2.8 years longer overall survival. This early knowledge leads to better survival most likely because these patients are carefully watched by their medical teams. However, knowing a patient has MGUS that can progress to myeloma can obviously cause emotional distress. It is important that if they are screened, that there is practical discussion between patient and doctor about what it means. The study did not include smoldering myeloma patients.
The use of metformin, a drug used for diabetics, is associated with reduced progression of MGUS to multiple myeloma. It delays myeloma by 4 years in patients with type 2 diabetes. Reduced risk is also associated with regular use of aspirin. Because behavior and easily accessible medicines can help delay progression, it is of interest to screen these folks with the goal of detecting MGUS early and reducing myeloma occurrences and death.
In prior studies it was found that patients who knew they had MGUS and progressed to myeloma had 2.8 years longer overall survival. This early knowledge leads to better survival most likely because these patients are carefully watched by their medical teams. However, knowing a patient has MGUS that can progress to myeloma can obviously cause emotional distress. It is important that if they are screened, that there is practical discussion between patient and doctor about what it means. The study did not include smoldering myeloma patients.
In contrast to screening in solid tumors, blood tests for MGUS are straightforward. The sensitivity of serum protein electrophoresis and free light chain testing for MGUS is close to 100%, and the specificity is 99%.
The authors conclude by saying that regular screening of MGUS candidates, especially those with a family history or higher incidence of myeloma, should be started as early as possible with biannual follow-up.
The authors conclude by saying that regular screening of MGUS candidates, especially those with a family history or higher incidence of myeloma, should be started as early as possible with biannual follow-up.
