Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management

Research output: Contribution to journalArticlepeer-review


  • R A Kyle
  • B G M Durie
  • S V Rajkumar
  • O Landgren
  • J Blade
  • G Merlini
  • N Kröger
  • H Einsele
  • D H Vesole
  • M Dimopoulos
  • J San Miguel
  • H Avet-Loiseau
  • R Hajek
  • W M Chen
  • K C Anderson
  • H Ludwig
  • P Sonneveld
  • S Pavlovsky
  • A Palumbo
  • P G Richardson
  • B Barlogie
  • P Greipp
  • R Vescio
  • I Turesson
  • J Westin
  • M Boccadoro
  • IMWG
  • Keith Wheatley


Monoclonal gammopathy of undetermined significance (MGUS) was identified in 3.2% of 21 463 residents of Olmsted County, Minnesota, 50 years of age or older. The risk of progression to multiple myeloma, Waldenstrom's macroglobulinemia, AL amyloidosis or a lymphoproliferative disorder is approximately 1% per year. Low-risk MGUS is characterized by having an M protein <15 g/l, IgG type and a normal free light chain (FLC) ratio. Patients should be followed with serum protein electrophoresis at six months and, if stable, can be followed every 2-3 years or when symptoms suggestive of a plasma cell malignancy arise. Patients with intermediate and high-risk MGUS should be followed in 6 months and then annually for life. The risk of smoldering (asymptomatic) multiple myeloma (SMM) progressing to multiple myeloma or a related disorder is 10% per year for the first 5 years, 3% per year for the next 5 years and 1-2% per year for the next 10 years. Testing should be done 2-3 months after the initial recognition of SMM. If the results are stable, the patient should be followed every 4-6 months for 1 year and, if stable, every 6-12 months.


Original languageEnglish
Pages (from-to)1121-7
Number of pages7
Issue number6
Publication statusPublished - Jun 2010


  • Disease Progression, Humans, Monoclonal Gammopathy of Undetermined Significance, Multiple Myeloma, Practice Guidelines as Topic, Prognosis, Risk Factors