ROCHESTER, Minnesota: An American Journal of Haematology review proposes strict criteria for monoclonal gammopathy of thrombotic significance, limiting confirmed MGTS to one M-protein-driven disorder.
The authors define MGTS as thrombosis supported by evidence that a monoclonal protein “directly contributes to thrombosis.” Such proteins arise from clonal plasma-cell or B-cell disorders.
The review identifies monoclonal protein-induced immune thrombocytopenia and thrombosis as the only condition currently meeting its criteria. This disorder involves an abnormal antibody that can activate platelets and promote clot formation.
Researchers classified thrombotic microangiopathy and antiphospholipid syndrome as provisional M-protein-associated syndromes. They said plausible biological mechanisms exist, but direct causal evidence remains insufficient.
The review narrows an earlier framework that applied MGTS more broadly to significant or recurring thrombotic events in people with monoclonal gammopathy of undetermined significance. That earlier peer-reviewed review appeared in Cancers in 2023.
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A subsequent case report in Blood documented recurrent thrombosis and thrombocytopenia associated with a persistent monoclonal antibody against platelet factor 4.
The new publication is a critical review, not a clinical trial or original dataset. Its authors call for agreed definitions, diagnostic criteria and evidence-based treatment strategies.
The review’s disclosures list industry relationships for Mayo Clinic haematologists S. Vincent Rajkumar and Shaji Kumar. Two other authors declared no conflicts.
