{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T02:00:08Z","timestamp":1773021608850,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T00:00:00Z","timestamp":1601337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002794","name":"Cancerfonden","doi-asserted-by":"publisher","award":["190190 Pj01"],"award-info":[{"award-number":["190190 Pj01"]}],"id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant clonal plasma cell disorder, with a 1% yearly risk of progression to multiple myeloma (MM). Evolution of M\u2010spike and serum free light chain (sFLC) during follow\u2010up could identify patients at high risk of progression. In this region\u2010wide study, including 4756 individuals, 987 patients with MGUS were identified, and baseline factors as well as evolving involved FLC (iFLC) were evaluated as potential markers for risk of progression from MGUS to MM. Furthermore, evolving iFLC and M\u2010spike were assessed quarterly for a median of 5\u2009years. At baseline, patients that progressed had significantly higher iFLC compared to non\u2010progressors. The risk factors of M\u2010spike &gt;1.5 g\/dL, age &gt;65\u2009years and iFLC &gt;100\u2009mg\/L were all independently associated with increased risk of MGUS to MM progression. For patients that had any two or three risk factors, the 5\u2010year cumulative probability of progression was significantly higher (31%) compared to no risk factors (2%). Evolving iFLC &gt;100\u2009mg\/L during follow\u2010up was consistently associated with increased risk of progression. Based on our observations, we propose to include iFLC as a monitoring tool for all MGUS patients. Furthermore, we recommend a quarterly monitoring in all high\u2010risk patients. Finally, we suggest that the risk of MGUS progression should be stratified with age, M\u2010spike, and iFLC at baseline.<\/jats:p>","DOI":"10.1002\/ajh.25999","type":"journal-article","created":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T23:40:22Z","timestamp":1600299622000},"page":"23-30","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comparative evaluation of involved free light chain and monoclonal spike as markers for progression from monoclonal gammopathy of undetermined significance to multiple myeloma"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6069-6615","authenticated-orcid":false,"given":"Charlotte","family":"Gran","sequence":"first","affiliation":[{"name":"Department of Medicine Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Clinical Chemistry Karolinska University Laboratory  Stockholm 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