{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:58:31Z","timestamp":1785333511260,"version":"3.55.0"},"reference-count":15,"publisher":"American Society of Hematology","issue":"9","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,2,27]]},"abstract":"<jats:sec>\n                  <jats:title>Abstract<\/jats:title>\n                  <jats:p>Hypercalcemia in monoclonal gammopathy of undetermined significance (MGUS) presents a clinical challenge because 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 Iceland Screens, Treats, or Prevents Multiple Myeloma screening study. Of the 75\u2009422 Icelanders aged 40\u00a0years and above who underwent screening for MGUS, we included 2546 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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1182\/blood.2024025624","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T22:01:59Z","timestamp":1734645719000},"page":"970-974","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":3,"title":["Approaching hypercalcemia in monoclonal gammopathy of undetermined significance: insights from the iStopMM screening study"],"prefix":"10.1182","volume":"145","author":[{"given":"\u00c1str\u00fan Helga","family":"J\u00f3nsd\u00f3ttir","sequence":"first","affiliation":[{"name":"1Faculty of Medicine, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helga \u00c1g\u00fasta","family":"Sigurj\u00f3nsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"2Department of Endocrinology, Landsp\u00edtali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5017-3530","authenticated-orcid":false,"given":"Sigrun","family":"Thorsteinsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"3Department of Hematology, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2377-7886","authenticated-orcid":false,"given":"Thorir Einarsson","family":"Long","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"4Department of Nephrology, Sk\u00e5ne University Hospital, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2353-573X","authenticated-orcid":false,"given":"Ingiger\u00f0ur S\u00f3lveig","family":"Sverrisd\u00f3ttir","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"5Department of Hematology, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Eythorsson","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"6Department of Internal Medicine, Landsp\u00edtali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9201-1166","authenticated-orcid":false,"given":"J\u00f3n \u00de\u00f3rir","family":"\u00d3skarsson","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"7Department of Clinical Biochemistry and Hematology, Landsp\u00edtali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6763-1702","authenticated-orcid":false,"given":"Runolfur","family":"Palsson","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"8Department of Nephrology, Landsp\u00edtali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olafur Skuli","family":"Indridason","sequence":"additional","affiliation":[{"name":"8Department of Nephrology, Landsp\u00edtali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brynjar","family":"Vi\u00f0arsson","sequence":"additional","affiliation":[{"name":"9Department of Hematology Landsp\u00edtali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5342-9148","authenticated-orcid":false,"given":"Pall Torfi","family":"Onundarson","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00cdsleifur","family":"\u00d3lafsson","sequence":"additional","affiliation":[{"name":"7Department of Clinical Biochemistry and Hematology, Landsp\u00edtali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingunn","family":"\u00deorsteind\u00f3ttir","sequence":"additional","affiliation":[{"name":"7Department of Clinical Biochemistry and Hematology, Landsp\u00edtali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjarni A.","family":"Agnarsson","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"10Department of Pathology, Landsp\u00edtali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margr\u00e9t","family":"Sigur\u00f0ard\u00f3ttir","sequence":"additional","affiliation":[{"name":"10Department of Pathology, Landsp\u00edtali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2374-9773","authenticated-orcid":false,"given":"\u00c1sbj\u00f6rn","family":"J\u00f3nsson","sequence":"additional","affiliation":[{"name":"11Department of Radiology, Akureyri Hospital, Akureyri, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9045-6495","authenticated-orcid":false,"given":"Malin","family":"Hultcrantz","sequence":"additional","affiliation":[{"name":"12Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, 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M.","family":"Durie","sequence":"additional","affiliation":[{"name":"13Samuel Oschin Comprehensive Cancer Institute, Cedar-Sinai Outpatient Cancer Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Harding","sequence":"additional","affiliation":[{"name":"14The Binding Site, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6485-4839","authenticated-orcid":false,"given":"Ola","family":"Landgren","sequence":"additional","affiliation":[{"name":"15Myeloma Program, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2680-6120","authenticated-orcid":false,"given":"Thorvardur Jon","family":"Love","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"16Department 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