Table 1 Characteristics of clonal B cell and plasma cell proliferative disorders

From: The evaluation of monoclonal gammopathy of renal significance: a consensus report of the International Kidney and Monoclonal Gammopathy Research Group

Disease

Clone

Bone marrow involvement

Immunoglobulin

M-spike

Organ damage and/or involvement

MGUS

Any

<10%

Any

<30 g/l

None

Smouldering MMa

Plasma cell

10–60%

Any

 ≥30 g/l

None

MMa

Plasma cell

 ≥10%

Any

 ≥30 g/l

SLiM CRAB: 60% bone marrow plasma cells, involved:uninvolved free light-chain ratio >100, >1 bone lesion on MRI, hypercalcaemia, renal impairment, anaemia and lytic bone lesions

Smouldering WMa

Lymphoplasmacytic lymphoma cloneb

 ≥10%

IgM

 ≥30 g/l

Absent

WMa

Lymphoplasmacytic lymphoma cloneb

 ≥10%

IgM

 ≥30 g/l

Anaemia, hyperviscosity, constitutional symptoms, bulky lymphadenopathy, hepatosplenomegaly and neuropathy

MBL

B-cell clonec

Peripheral B-cell count <5 × 109/l

Any

Any

Absence of lymph node involvement

CLL

B-cell clonec

Peripheral B-cell count >5 × 109/l

Any

Any

Adenopathy, anaemia and thrombocytopenia

Other B cell lymphoproliferative disorders

Pan B-cell markers (CD19+CD20+CD79+CD22+PAX5+)

Presence or absence

Any

Any

Adenopathy and splenomegaly

  1. CLL, chronic lymphocytic leukaemia; MBL, monoclonal B cell lymphocytosis; MGUS, monoclonal gammopathy of undetermined significance; MM, multiple myeloma; SLiM CRAB, symptomatic, light chains, MRI, high calcium, renal dysfunction, anaemia, and bony lytic lesions; WM, Waldenström macroglobulinaemia. aEither bone marrow involvement or an M-spike above these thresholds is sufficient for the diagnosis. bTypically, B cells are surface IgM+CD5CD10CD11cCD19+CD20+CD22+CD23CD25+CD27+FMC7+CD103CD138 with a plasmacytic component that is CD138+CD38+CD19+CD45+CD56. cCD5+CD19+CD23+surface immunoglobulin+CD20dim.