What is the significance of monoclonal gammopathy of undetermined significance?

Abstract

Monoclonal gammopathy of undetermined signifi cance (MGUS) is characterised by the presence of a monoclonal paraprotein in the blood, without the characteristic end organ damage seen in multiple myeloma. MGUS is more common in older age groups and has a risk of progression to myeloma of 1% per year. Population screening is not currently recommended, but retrospective studies have suggested improvements in myeloma outcomes in those under MGUS follow-up; in addition, MGUS has associated complications, including fracture, osteoporosis, renal disease and infection, which can be treated. Given this increasing evidence of disease related directly to MGUS, strategies for early identifi cation might be needed. In this review, we discuss the complications of MGUS and whether MGUS fulfi ls the criteria needed to implement a screening programme. We also highlight areas where more evidence is needed, including identifi cation of a higher risk population to make screening more practical and economically viable.