Monoclonal Gammopathy of Undetermined Significance and Smoldering Myeloma

Monoclonal Gammopathy of Undetermined Significance (MGUS) and Smoldering Myeloma (SMM) describe pre-malignant conditions that are defined by the presence of monoclonal immunoglobulin production. They are found in up to 3% of individuals over the age of 50 with a rate of progression to multiple myeloma or other related malignancy of approximately 1% per year. Accurate diagnosis and risk-stratification are paramount to prevent end-organ damage and determine follow-up intervals. With the data currently available, treatment for MGUS is not recommended. Patients with newly diagnosed high- risk SMM should be referred to a centre and therapy with lenalidomide plus/minus dexamethasone for 2 years or participation in a clinical trial should be discussed.