Part 7: Monoclonal gammopathy for the non-hematologist oncologist

this article continues a series on literature-based followup recommendations for conditions commonly encountered in general oncology practice. The accidental discovery of a monoclonal gammopathy (monoclonal protein or M protein, M spike) becomes increasingly common with advanced patient age, affecting approximately 3% to 4% of those over age 50, 5% over age 65 and almost 10% of those 85 or older. 1-4 Since adult oncology practice is largely concerned with individuals 60 years and older, all oncologists require some familiarity with the investigation, natural history, followup and timing of subspecialist referral of patients with monoclonal gammopathy of undetermined significance (MGUS). Earlier studies suggest that in over 50% of patients in whom an M protein was accidentally detected, no subsequent followup was actually undertaken. 5