Monoclonal Gammopathy

Monoclonal Gammopathy designates disorders characterised by proliferation of a single clone of plasma cells producing abnormal amounts of monoclonal immunoglobulin, detected through serum or urine protein electrophoresis as distinct bands representing structurally identical antibody molecules secreted by the expanded clone. These conditions range from benign monoclonal gammopathy of undetermined significance through smouldering multiple myeloma, to malignant multiple myeloma causing bone destruction, renal failure, anaemia, and hypercalcaemia.

The biopharmaceutical industry has revolutionised multiple myeloma treatment through novel therapeutics including proteasome inhibitors like bortezomib, immunomodulatory drugs such as lenalidomide, monoclonal antibodies including daratumumab targeting CD38, and CAR-T cell therapies like idecabtagene vicleucel targeting BCMA-expressing myeloma cells. These advances transformed multiple myeloma from a rapidly fatal disease to a chronic condition with significantly extended survival. Diagnosis and monitoring employ serum protein electrophoresis, immunofixation, free light chain assays, and bone marrow examination. As understanding deepens regarding disease biology, minimal residual disease assessment becomes standard for evaluating treatment responses, and novel agents target resistance mechanisms, outcomes continue improving through personalised treatment approaches guided by molecular profiling.