Understanding Monoclonal Gammopathy of Undetermined Significance

Authors

Scott Winkel MSPH, MHS, PA-C, University of LynchburgFollow

Abstract

Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant plasma cell disorder characterized by serum monoclonal protein (M-protein) levels less than 3.0 g/dL, less than 10% plasma cells in the bone marrow, and absence of end-organ damage. It mainly affects older adults and is often an incidental finding. While most cases remain indolent, a subset progresses to malignancies such as multiple myeloma, smoldering myeloma, AL amyloidosis, lymphoproliferative disorders, macroglobulinemia, and monoclonal gammopathy of renal significance. This review summarizes current insights into MGUS pathophysiology, risk factors, molecular mechanisms, clinical features, diagnostic approaches, including laboratory assessments and imaging, and emphasizes early detection of progression. It explores management strategies and emerging therapies, such as celecoxib and glucagon-like peptide-1 receptor agonists (GLP-1 RA) aiming to delay or prevent transformation. Future directions focus on refining screening and developing personalized therapies to improve outcomes.

Recommended Citation

Winkel, Scott MSPH, MHS, PA-C (2026) "Understanding Monoclonal Gammopathy of Undetermined Significance," Lynchburg Journal of Medical Science: Vol. 2: Iss. 1, Article 1.
DOI: https://doi.org/10.63932/3067-7106.1054
Available at: https://digitalshowcase.lynchburg.edu/jms/vol2/iss1/1