Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Approaching Hypercalcemia in Monoclonal Gammopathy of Undetermined Significance : Insights from the iStopMM study

Jónsdóttir, Ástrún Helga ; Sigurjónsdóttir, Helga Ágústa ; Thorsteinsdottir, Sigrun ; Einarsson Long, Thorir LU ; Sverrisdóttir, Ingigerður Sólveig ; Eythorsson, Elias ; Oskarsson, Jon Thorir ; Pálsson, Runólfur ; Indridason, Olafur Skuli and Vidarsson, Bryjnar , et al. (2024) In Blood
Abstract

Hypercalcemia in monoclonal gammopathy of undetermined significance (MGUS) presents a clinical challenge since 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 iStopMM screening study. Of the 75,422 Icelanders aged 40 years and above who underwent screening for MGUS, we included 2,546 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... (More)

Hypercalcemia in monoclonal gammopathy of undetermined significance (MGUS) presents a clinical challenge since 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 iStopMM screening study. Of the 75,422 Icelanders aged 40 years and above who underwent screening for MGUS, we included 2,546 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.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
publishing date
type
Contribution to journal
publication status
epub
subject
in
Blood
publisher
American Society of Hematology
external identifiers
  • scopus:85215835823
  • pmid:39700506
ISSN
1528-0020
DOI
10.1182/blood.2024025624
language
English
LU publication?
no
additional info
Copyright © 2024 American Society of Hematology.
id
bafa5bce-1566-4522-bbc3-4af1f6855809
date added to LUP
2024-12-22 13:56:47
date last changed
2025-07-15 11:08:14
@article{bafa5bce-1566-4522-bbc3-4af1f6855809,
  abstract     = {{<p>Hypercalcemia in monoclonal gammopathy of undetermined significance (MGUS) presents a clinical challenge since 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 iStopMM screening study. Of the 75,422 Icelanders aged 40 years and above who underwent screening for MGUS, we included 2,546 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.</p>}},
  author       = {{Jónsdóttir, Ástrún Helga and Sigurjónsdóttir, Helga Ágústa and Thorsteinsdottir, Sigrun and Einarsson Long, Thorir and Sverrisdóttir, Ingigerður Sólveig and Eythorsson, Elias and Oskarsson, Jon Thorir and Pálsson, Runólfur and Indridason, Olafur Skuli and Vidarsson, Bryjnar and Onundarson, Pall T and Olafsson, Isleifur and Þorsteinsdóttir, Ingunn and Agnarsson, Bjarni A and Sigurdardottir, Margret and Jonsson, Asbjorn and Hultcrantz, Malin L and Durie, Brian G M and Harding, Stephen and Landgren, Carl Ola and Love, Thorvardur Jon and Kristinsson, Sigurdur Yngvi and Rögnvaldsson, Sæmundur}},
  issn         = {{1528-0020}},
  language     = {{eng}},
  month        = {{12}},
  publisher    = {{American Society of Hematology}},
  series       = {{Blood}},
  title        = {{Approaching Hypercalcemia in Monoclonal Gammopathy of Undetermined Significance : Insights from the iStopMM study}},
  url          = {{http://dx.doi.org/10.1182/blood.2024025624}},
  doi          = {{10.1182/blood.2024025624}},
  year         = {{2024}},
}