Plasma Cell Dyscrasia Comprehensive Overview

Plasma cell dyscrasias are clonal proliferations of plasma cells producing monoclonal immunoglobulin protein. The spectrum ranges from monoclonal gammopathy of undetermined significance through smoldering myeloma to symptomatic multiple myeloma. Each entity has distinct diagnostic criteria and treatment implications.

MGUS is defined by serum monoclonal protein under three grams per deciliter clonal plasma cells under ten percent and absence of end organ damage with progression risk approximately one percent yearly. Smoldering myeloma has higher tumor burden but no end organ damage. Multiple myeloma requires CRAB criteria of hypercalcemia renal failure anemia or bone lesions.

Other plasma cell dyscrasias include AL amyloidosis with light chain deposition causing organ dysfunction Waldenstrom with IgM monoclonal gammopathy and lymphoplasmacytic infiltrate POEMS syndrome and solitary plasmacytoma. Initial workup includes serum and urine protein electrophoresis immunofixation free light chains skeletal survey and bone marrow examination.