Monoclonal gammopathy of renal significance (MGRS): Real-world data on outcomes and prognostic factors

Alessandro Gozzetti*, Andrea Guarnieri, Elena Zamagni, Elena Zakharova, Daniel Coriu, Max Bittrich, Tomáš Pika, Natalia Tovar, Natalia Schutz, Sara Ciofini, Camila Peña, Serena Rocchi, Michael Rassner, Irit Avivi, Anna Waszczuk-Gajda, Saurabh Chhabra, Lidia Usnarska-Zubkiewicz, Verónica González-Calle, Maria Victoria Mateos, Monica BocchiaFlavia Bigi, Hannah Füllgraf, Bhavna Bhasin-Chhabra, Massimo Gentile, Julio Davila, David H. Vesole, Michele Cavo, Bicky Thapa, Edvan Crusoe, Hermann Einsele, Wojciech Legiec, Grzegorz Charliński, Artur Jurczyszyn

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Monoclonal gammopathy of renal significance (MGRS) is a recognized clinical entity. Literature regarding treatment and its outcomes in MGRS is sparse due to the rarity and misdiagnosis of MGRS. We retrospectively analyzed 280 adults with an MGRS diagnosis from 2003 to 2020 across 19 clinical centers from 12 countries. All cases required renal biopsy for the pathological diagnosis of MGRS. Amyloidosis-related to MGRS (MGRS-A) was present in 180 patients; nonamyloidosis MGRS (MGRS-NA), including a broad spectrum of renal pathologies, was diagnosed in 100 patients. The median overall survival in the studied cohort was 121.0 months (95% CI: 105.0–121.0). Patients with MGRS-A had a shorter overall survival than patients with MGRS-NA (HR = 0.41, 95%CI: 0.25–0.69; p = 0.0007). Both hematologic and renal responses were associated with longer survival. Achievement of ≥VGPR was generally predictive of a renal response (OR = 8.03 95%CI: 4.04–115.96; p < 0.0001), one-fourth of patients with ≥VGPR were renal nonresponders. In MGRS-A, factors associated with poor prognosis included elevated levels of creatinine, beta-2-microglobulin, and hemodialysis at diagnosis. In MGRS-NA, only age >65 years was associated with increased risk of death. Treatments provided similar hematologic response rates in both types of MGRS. Autologous stem cell transplantation led to better response than other treatments. This multicenter and international effort is currently the largest report on MGRS.

Original languageEnglish
Pages (from-to)877-884
Number of pages8
JournalAmerican Journal of Hematology
Issue number7
StatePublished - Jul 2022


FundersFunder number
Università degli Studi di Siena


    Dive into the research topics of 'Monoclonal gammopathy of renal significance (MGRS): Real-world data on outcomes and prognostic factors'. Together they form a unique fingerprint.

    Cite this