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Review: Monoclonal Gammopathy of Undetermined Significance

Jack Cush, MD Oct 09, 2025

NEJM has reviewed the common hematologic/immunologic finding of "monoclonal gammopathy of undetermined significance" (MGUS) - a common premalignant plasma-cell proliferative disorder found in approximately 5% of those over age of 50 years.

Article

Multimorbidity predicts flares in rheumatoid arthritis

Jack Cush, MD Sep 05, 2025

A study from Olmstead county and the Mayo Clinic shows that multimorbidity and social factors predict higher rheumatoid arthritis (RA) flares and lower remission rates.

Article

September to Remember (9.5.2025)

Jack Cush, MD Sep 05, 2025

Dr. Jack Cush reviews the news and journal reports from RheumNow. This week - unemployment, diagnosing Sjogren's and a lot of ILD.

Survival outcomes in patients with axial SpA and concomitant cancer are the same as those without. #abst1429 #ACR25 @RheumNow https://t.co/wicN3s9JrR

https://x.com/bella_mehta/status/1982858037162586275/photo/1

Need better lymphoma biomarkers in Sjögren’s? APRIL joins BAFF as a promising candidate—high APRIL levels linked to ↑ B-cell activation, disease activity & future lymphoma. Easily measurable, potentially targetable. @RheumNow #ACR25 Abstract #1683

In Sjögren’s, cancer risk is real. >9yr multicenter cohort (n=314), overall cancer risk ↑ (SIR 1.68), NHL >15× expected Predictors: older age, smoking, LAD, splenomegaly, cryoglobulinemia (strongest for lymphoma). Malignancies = 24% of deaths @RheumNow #ACR25 Abstract #1681

#ACR25 Abstr#663 “Off-the-Shelf” iPSC-derived CAR-T is coming soon! Promising data on 8 #SLE patients in Phase 1. Advantages over autologous/allogenic: -No apheresis -No conditioning chemo -Shorter hospital stays ~3 days -Ability to redose in partial responder @RheumNow https://t.co/pbem7A5Iq5

A retrospective study from Spain assessed the relationship bet HPV infxn & biologic tx in SLE pts 🔅 Prevalence of HPV 9.9% 🔅 No significant assocs bet HPV infxn, biologic tx, SLE-related dse variables & HPV RF progression Still, emphasize HPV screening #ACR25 @RheumNow Abs0659 https://t.co/1YusM1nYPr

https://x.com/RHEUMarampa/status/1982511293178491235/photo/1

#Cancers esp #hematologic & #lung are ⬆️in Pts w #inflammatory #rheum #diseases Odds ratios of hem malignancies are wide & risk stratification is imp Are we doing a good job? 🤔skin cancer screening ??- not as per general standards Abst#0172 #ACR25 @RheumNow @ACRheum https://t.co/Uve9knXD3o

Review: Monoclonal Gammopathy of Undetermined Significance NEJM has reviewed the common hematologic/immunologic finding of "monoclonal gammopathy of undetermined significance" (MGUS) - a common premalignant plasma-cell proliferative disorder found in approximately 5% of those https://t.co/kleuYayTZW

What is IPAF? Idiopathic Interstitial Pneumonia with Autoimmune Features - or IPAF - describes patients with interstitial pneumonia with autoimmune features, but they don’t meet a diagnosis of a CTD. https://t.co/ZEexaqoeLK https://t.co/p3Yfv2IkE2

What is IPAF? | RheumNow

Interstitial lung abnormalities (ILA) are found in 7% of Gen. population, most of whom are asymptomatic, but some will progress to ILD, IPF,and increased risk of lung cancer, etc. Finding incidental ILD appropriate screening monitoring, based on risk factors is indicated. https://t.co/kQbhxTAVTm

CAR-T Product Shows Early Promise in Lupus Five patients with systemic lupus erythematosus (SLE) in China have been treated with a potentially groundbreaking form of chimeric antigen receptor (CAR) T-cell therapy, researchers reported, with encouraging results after 3 months. https://t.co/eg37PZK6kn

What are the Pros and Cons of autologous CAR T cell therapy? Summary slide from Georg Schett who also mentioned the exciting in vivo CAR approach using nanoparticules in myeloma, something to stay tuned for @RheumNow #APLAR25 https://t.co/kWjrx6N9Dv

Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease A matched cohort study from the Veterans Health Administration shows that RA patients have a >50% increased risk of lung cancer, a 3-fold higher risk of lung cancer in RA-ILD. https://t.co/Gjn2M2CNAO https://t.co/DPgDQsCWK9

Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease | RheumNow

Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease | RheumNow

Retrospective French Health Data System Immune Checkpt inhibitor (ICI) study. Of 172,363 ICI-Rx adult pts, ICI myotoxicities at 6 months ranged from 0.7% -0.9%. ICI myocarditis & myositis incidence was 0.3%- 0.6%, co-occurring in ∼13–23%. ICI myotoxicity- 1-mo fatality was https://t.co/kOGKM8lC0H

Review of cancer-associated myositis (CAM) & assoc myositis-specific or myositis-associated autoantibodies. 2017 meta-analysis 5 studies & 4538 pts w/ DM or PM, the cancer risk (SIR) for DM = 4.66, but PM = 1.75. Cancer risk ^^ w/ Low serum KL-6, TIF1γ, NXP2, HMGCR Abs https://t.co/xsOt4wPIXB

High cancer risk in myositis patients linked to autoantibodies- TIFF1g, NXP2, HMGCR. https://t.co/CECO78ESHi

RA has lower risk of colorectal cancer (CRC). Korean claims compared 41K RA pts 1:5 vs 204K non-RA. RA had signif. decreased risk for CRC (HR 0.89), main in seroneg RA (HR 0.79) but not seropos RA (HR 0.93). Inverse assoc mainly w/ rectal CA (HR 0.63) & women (HR 0.80). https://t.co/dudG4Is5oj

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Review: Monoclonal Gammopathy of Undetermined Significance

Multimorbidity predicts flares in rheumatoid arthritis

September to Remember (9.5.2025)

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