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ASH 2025 | Monoclonal light chain glycosylation is associated with evolution of incidental MGUS
Karthik Ramasamy, MBBS, MRCP, FRCPath, PhD, Oxford University Hospitals NHS Foundation Trust, Oxford, UK, discusses a pilot study that suggests there is a possible association between monoclonal light chain glycosylation and monoclonal gammopathy of undetermined significance (MGUS) evolution, with early results indicating that incidental MGUS patients have a higher level of glycosylation compared to those actively screened for MGUS. This interview took place at the 67th ASH Annual Meeting and Exposition, held in Orlando, FL.
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Transcript
MGUS is incidentally identified in clinical practice. The iSTOP-MM study is looking at whether we should screen for MGUS. In the UK, incidental MGUS detection continues to go up as both primary care doctors and secondary care doctors are doing paraprotein tests. We have a machine called Exent which is a mass spec machine, which can detect glycosylation both in heavy chains and light chains of patients...
MGUS is incidentally identified in clinical practice. The iSTOP-MM study is looking at whether we should screen for MGUS. In the UK, incidental MGUS detection continues to go up as both primary care doctors and secondary care doctors are doing paraprotein tests. We have a machine called Exent which is a mass spec machine, which can detect glycosylation both in heavy chains and light chains of patients. And using this test, we started to analyze if there are differences in the level of glycosylation in incidental MGUS patients in comparison with what has been reported in screened MGUS patients at the Mayo Clinic. And our early results suggest that the incidental MGUS patients have a higher level of glycosylation, over 10%, in comparison to what has been detected in the screened MGUS patients, about 6%. What we intend to do is to look at the significance of whether the glycosylated MGUS patients evolve more, and some early results suggest that that may be the case, but we need a larger data set to be certain and think about incorporating this as a feature for high-risk MGUS monitoring.
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