The illustrious Dr. Laura Kim gave a great noon rounds on plasma cell dyscrasias and monoclonal gammopathies of clinical significance (MGCS).
See her teaching slide deck here.
Key monoclonal band differential:
- MGUS (monoclonal gammopathy of unknown significance)
- Smouldering myeloma
- Multiple myeloma
- There are new exciting treatment options for relapsed/ refractory MM with teclistamab (bispecific antibody) and cilta-cel (CAR T-cell therapy)
- Plasmacytoma
- AL amyloidosis
- MGCS (monoclonal gammopathy of clinical significance)
- POEMS (polyradiculoneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes)
- Clarkson syndrome/ systemic capillary leak syndrome
- TEMPI (telangiectasia, elevated EPO and erythrocytosis, monoclonal gammopathy, perinephric fluid collections, intrapulmonary shunting)
- Cutaneous MGCS: Schnitzler’s syndrome, scleromyxedema, necrobiotic xanthogranuloma
- (not discussed today) Lymphomas
- Waldenstrom’s macroglobulinemia/ lymphoplasmacytic lymphoma
- CLL/ SLL
- Marginal zone lymphoma
- Mantle cell lymphoma
Vancouver IM LMR 
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