ABSTRACT
BACKGROUND: Monoclonal gammopathy of undetermined significance (MGUS) is a plasma cell proliferative disorder that transforms into multiple myeloma and other serious B-cell disorders at an approximate rate of 1% per year; these patients are also at increased risk for fractures. PATIENTS AND METHODS: We conducted a retrospective, multicenter study of 100 patients from seven community health clinics to gain a better understanding of the work-up, follow-up, and treatment of these patients. RESULTS: MGUS patients appear to undergo inadequate work-up, follow-up, and treatment in the community setting. CONCLUSIONS: Physicians should adhere to recently established guidelines to ensure that MGUS patients receive optimal care for this condition.
Subject(s)
Diphosphonates/therapeutic use , Monoclonal Gammopathy of Undetermined Significance/diagnosis , Monoclonal Gammopathy of Undetermined Significance/therapy , Adult , Bone Density , Diagnosis, Differential , Disease Progression , Early Diagnosis , Female , Follow-Up Studies , Fractures, Bone/etiology , Humans , Laboratory Proficiency Testing/methods , Male , Middle Aged , Monoclonal Gammopathy of Undetermined Significance/complications , Multiple Myeloma/etiology , Retrospective StudiesABSTRACT
Uracil mustard was used for the treatment of thrombocytosis in 14 patients, eight who had polycythemia vera and six who had essential thrombocytosis. Intermittent treatment with 1 to 2 mg/day for 14 days was used for most patients, and continuous treatment was used for three patients. The nadir of the platelet count occurred during a mean period of five to seven weeks, and the mean duration between courses was seven months. The drug selectively depressed the platelet count, with a minimal effect on leukocytes and erythrocytes. Uracil mustard is an effective drug for the control of thrombocytosis.