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Prevalence of Monoclonal Gammopathy of Undetermined Significance
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BACKGROUND: The prevalence of monoclonal gammopathy of undetermined significance (MGUS), a premalignant plasma-cell disorder, among persons 50 years of age or older has not been accurately determined. We used sensitive laboratory techniques to ascertain the prevalence of MGUS in a large population in a well-defined geographic area. METHODS: We identified all living residents of Olmsted County, Minnesota, as of January 1, 1995. We obtained serum that remained after the performance of routine clinical tests at Mayo Clinic or asked subjects for whom such serum was unavailable to provide a sample. Agarose-gel electrophoresis was performed on all serum samples, and any serum sample with a discrete band of monoclonal protein or thought to have a localized band was subjected to immunofixation. RESULTS: Serum samples were obtained from 21,463 of the 28,038 enumerated residents 50 years of age or older (76.6 percent). MGUS was identified in 694 (3.2 percent) of these persons. Age-adjusted rates were higher in men than in women (4.0 percent vs. 2.7 percent, P<0.001). The prevalence of MGUS was 5.3 percent among persons 70 years of age or older and 7.5 percent among those 85 years of age or older. The concentration of monoclonal immunoglobulin was less than 1.0 g per deciliter in 63.5 percent and at least 2.0 g per deciliter in only 4.5 percent of 694 persons. The concentration of uninvolved immunoglobulins was reduced in 27.7 percent of 447 persons tested, and 21.5 percent of 79 tested had a monoclonal urinary light chain. CONCLUSIONS: Among residents of Olmsted County, Minnesota, MGUS was found in 3.2 percent of persons 50 years of age or older and 5.3 percent of persons 70 years of age or older.
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“This tumor does not develop rapidly; instead, it may take decades for symptoms and organ damage to manifest.4-8”
From Evolution of Multiple Myeloma from a Genomic Perspective (2026) · cites this paper as [5]
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“MM is well-described to be universally preceded by precursor states, often decades before it is even diagnosed.”
From Evolution of Multiple Myeloma from a Genomic Perspective (2026) · cites this paper as [5]
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“Several epidemiological studies have shown that patients with MGUS and SMM might experience progression to MM over an extremely variable timeframe. Some patients progressed to MM within 2 years of diagnosis, while others may progress after 10 to 20 years or might never progress at all.4-6,75”
From Evolution of Multiple Myeloma from a Genomic Perspective (2026) · cites this paper as [5]
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Comprehensive genomic analysis identifying heterogeneity in peripheral T‐cell lymphoma
Yoshida, N., Yamada, K., & Ohshima, K. (2021) · Cancer Science · doi:10.1111/cas.14849 · Cited by 6
Paraproteinemias and Peripheral Nerve Disease
Leavell, Y. L., & Shin, S. C. (2021) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2021.01.004 · Cited by 6
Clinicopathological characteristics of patients with paraproteinemia and renal damage
Tang, X., Wan, F., Yü, J., Li, X., Yang, R., & Zhu, B. (2021) · European journal of medical research · doi:10.1186/s40001-021-00538-2 · Cited by 6
“According to data from the Mayo Clinic in the United States, the incidence rate of MGUS can be as high as 3% in Caucasians aged over 50 years [2, 3].”
MethodBai, Z., Hu, C., Zhong, J., & Dong, L. (2022) · Modern Rheumatology · doi:10.1093/mr/roac066 · Cited by 6
Kinase Inhibition in Multiple Myeloma: Current Scenario and Clinical Perspectives
Barreto, I. V., Machado, C. B., Almeida, D. B., Pessoa, F. M. C. D. P., Gadelha, R. B., Pantoja, L. D. C., Oliveira, D. D. S., Ribeiro, R. M., Lopes, G. S., de Moraes, M. O., et al. (2022) · Pharmaceutics · doi:10.3390/pharmaceutics14091784 · Cited by 6
Lewis, E., Lee, H., Fine, N. M., Miller, R. J. H., Hahn, C., Tay, J., Chhibber, S., Mahé, E., & Jimenez-Zepeda, V. H. (2022) · Clinical Lymphoma Myeloma & Leukemia · doi:10.1016/j.clml.2022.12.012 · Cited by 6
Saldanha, A., Veiga, M. E., Okazaki, E., Rothschild, C., Martınez, G., Rocha, V., Orsi, F. A., & Villaça, P. R. (2023) · Journal of Thrombosis and Thrombolysis · doi:10.1007/s11239-023-02799-6 · Cited by 6
“presence of a monoclonal paraprotein without evidence of multiple myeloma or other lymphoplasmacytic malignancies [1, 2].”
BackgroundJamet, B., Nécib, H., Carlier, T., Frampas, É., Bazin, J., Desfontis, P.-H., Monnet, A., Bodet‐Milin, C., Moreau, P., Touzeau, C., et al. (2024) · Cancer Imaging · doi:10.1186/s40644-024-00740-5 · Cited by 6
Tete, S. M., Horst, G., Wilting, K. R., Klijn, M. A., Westra, J., de Haan, A., Huckriede, A. L. W., Kluin‐Nelemans, H. C., Sahota, S. S., Bijl, M., et al. (2013) · Hematology and Leukemia · doi:10.7243/2052-434x-1-3 · Cited by 6
“MGUS is associated with a lifelong risk of progression to multiple myeloma or other related malignancy at a rate of 1% per year [1].”
BackgroundGregersen, H., Thomsen, C. B., Haglund, A., Mortensen, R. N., Andersen, N. F., & Nørgaard, M. (2013) · Clinical Epidemiology · doi:10.2147/clep.s50757 · Cited by 6
“Introduction Monoclonal gammopathy of undetermined significance (MGUS) is the most common immunoglobulin (Ig) disorder, with an estimated prevalence of 5% in persons above 70 years of age.(1) Patients with MGUS are at increased risk of malignant transformation to symptomatic malignant monoclonal gammopathy, most often…”
BackgroundSerum free light chain analysis in multiple myeloma and plasma cell dyscrasias
Özsan, G. H., & Dispenzieri, A. A. (2010) · Expert Review of Clinical Immunology · doi:10.1586/eci.10.80 · Cited by 6
Self-citationMonoclonal Gammopathy of Undetermined Significance and Multiple Myeloma in Older Adults
Guerard, E. J., & Tuchman, S. A. (2015) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2015.08.012 · Cited by 7
“5% of people greater than or equal to 85 years old.(1) The median age at diagnosis of MM”
BackgroundInitial Finding of Mandible Mass in Multiple Myeloma
Wei, H., Pinting, L., En-yi, T., & Zhiyong, W. (2012) · Journal of Craniofacial Surgery · doi:10.1097/scs.0b013e31826bf44c · Cited by 6
My Patient with Monoclonal Gammopathy of Undetermined Significance has a Kidney Problem
Leung, N. (2017) · Journal of Onco-Nephrology · doi:10.5301/jo-n.5000005 · Cited by 6
High prevalence of monoclonal gammopathy among patients with warm autoimmune hemolytic anemia
Ravindran, A., Sankaran, J., Jacob, E. K., Kreuter, J. D., Hook, C. C., Gertz, M. A., Call, T. G., Pruthi, R. K., Litzow, M. R., Wolanskyj, A. P., et al. (2017) · American Journal of Hematology · doi:10.1002/ajh.24765 · Cited by 6
“2%.(9,10) In our study, the prevalence of monoclonal gammopathy among WAIHA patients 50 years was 23.”
Self-citationMultiple Myeloma and Change of ABO Blood Group Type: A Case Report
Waleed, M. S., & Sadiq, W. (2020) · Cureus · doi:10.7759/cureus.10654 · Cited by 6
“Three percent of the population above the age of 50 have monoclonal gammopathy of undetermined significance (MGUS) that can further turn into a malignancy at a rate of approximately 1% per year [3,4].”
BackgroundLindemann, C. H., Enders, P., Brinkkoetter, P. T., & Völker, L. A. (2021) · BMC Nephrology · doi:10.1186/s12882-021-02309-x · Cited by 6
Kidney Transplantation and Monoclonal Gammopathy of Undetermined Significance
Aslam, N., Trautman, C. L., & Sher, T. (2021) · Transplantation Direct · doi:10.1097/txd.0000000000001176 · Cited by 6
Hafian, H., Schvartz, H., Patey, M., & Quinquenel, A. (2021) · BMC Oral Health · doi:10.1186/s12903-021-01960-y · Cited by 6
“Discussion MGUS is present in roughly 3–4% of the population over 50 years of age and in approximately 5% of those older than 70 years [3] and virtually precedes the development of MM and related disorders, i.”
BackgroundChina's potential role in humanitarian assistance
Binder, A., & Conrad, B. (2009) · Cited by 6
Johansson, P., Alig, S., Richter, J., Hanoun, C., Rekowski, J., Dürig, J., Ylstra, B., de Jong, D., Klapper, W., Alizadeh, A. A., et al. (2023) · Annals of Hematology · doi:10.1007/s00277-023-05393-1 · Cited by 6
A rare condition: IgE type monoclonal gammopathy of undetermined significance
Caldini, A. L., Balboni, F., Parronchi, P., Scoccianti, S., Biagioli, T., Terreni, A., Morrocchi, B., Brogi, M., Berardi, M., & Graziani, M. (2014) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2014-0182 · Cited by 6
“The frequency of the monoclonal gammopathies (MG) isotype roughly reflects their serum concentrations [1]; accordingly, IgE MG are the less frequent, and IgE mul tiple myeloma (MM) is also very rare.”
BackgroundSantiago, T. M. G., Lehman, J. S., Buonaccorsi, J. N., Kalaaji, A. N., & Wieland, C. N. (2015) · Journal of Cutaneous Pathology · doi:10.1111/cup.12657 · Cited by 6
Extramedullary Plasmacytoma Diagnosed in an HIV-Positive Patient by an Unusual Clinical Presentation
Moraes, P. D. C., Thomaz, L. A., Montalli, V. Â. M., Junqueira, J. L. C., Panjwani, C. M. B. R. G., & Oliveira, L. B. (2016) · Case Reports in Dentistry · doi:10.1155/2016/6305173 · Cited by 6
Abnormal Plasma Cell Disorders in Refinery Waste Workers
Ledda, C., Loreto, C., Filetti, V., Matera, S., Vitale, E., Bracci, M., & Rapisarda, V. (2018) · Journal of Clinical Medicine · doi:10.3390/jcm7080221 · Cited by 6
“2% of prevalence for MGUS in the Caucasian general 50-years of age or older population [7].”
BackgroundHellqvist, E., Kvarnström, M., Söderberg, A., Vrethem, M., Ernerudh, J., & Rosén, A. (2009) · Haematologica · doi:10.3324/haematol.2009.015123 · Cited by 6
“3% among people over 70 years old.(1) The disease course is different for immunoglobulin (Ig) G or IgA producing MGUS, as compared to MGUS of IgM class (IgM MGUS).”
BackgroundAlejo, E., González‐Calle, V., Blázquez, P. M., Puertas, B., Agulló, C., Rey-Búa, B., Gutierrez, N. C., Puig, N., & Mateos, M. (2025) · Blood Cancer Journal · doi:10.1038/s41408-025-01371-0 · Cited by 5
Protein Electrophoresis and Immunofixation for the Diagnosis of Monoclonal Gammopathies
Rajkumar, S. V., & Kyle, R. A. (2014) · JAMA · doi:10.1001/jama.2014.8237 · Cited by 5
Self-citationClinical specificity of two assays for immunoglobulin kappa and lambda free light chains
Farnsworth, C. W., Roemmich, B., Spears, G. M., Murray, D. L., Dispenzieri, A. A., & Willrich, M. A. V. (2023) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2023-0912 · Cited by 5
Self-citationMonoclonal gammopathy‐associated peripheral neuropathies: Uncovering pearls and challenges
Gonçalves, T. A. P., Donadel, C. D., Frezatti, R. S. S., Garibaldi, P. M. M., Calado, R. T., Marques, W., & Tomaselli, P. J. (2024) · Journal of the Peripheral Nervous System · doi:10.1111/jns.12638 · Cited by 5
Borges, G. Á., Diaz‐delCastillo, M., Guilatco, A. J., El-Masri, B. M., Mustapha, F., Gundesen, M. T., Hinge, M., Lund, T., Abdallah, N. H., Baughn, L. B., et al. (2025) · Leukemia · doi:10.1038/s41375-025-02572-z · Cited by 5
Zhang, H., Yao, Y., Zhang, X., Ji, X., Wu, T., Wang, J., & Fang, Y. (2025) · BMC Public Health · doi:10.1186/s12889-025-22688-2 · Cited by 5
Metadata
- Authors
- Kyle, R. A., Therneau, T. M., Rajkumar, S. V., Larson, D. R., Plevak, M. F., Offord, J. R., Dispenzieri, A., Katzmann, J. A., & Melton, L. J.
- Affiliations
- Mayo Clinic (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2006-03-30
- Volume
- 354
- Issue
- 13
- Pages
- 1362-1369
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2086990334
- Cited by
- 1,423
- References
- 22
- Citations by year
- 2026: 56 · 2025: 80 · 2024: 90 · 2023: 71 · 2022: 83 · 2021: 88 · 2020: 93 · 2019: 77 · 2018: 64 · 2017: 73 · 2016: 66 · 2015: 60 · 2014: 66 · 2013: 78 · 2012: 70
- FWCI
- 33.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (CA 107 476, CA6 2242, R01CA107476, P01CA062242)
- Topics
- Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
- Health Sciences › Medicine › Hematology › Chronic Lymphocytic Leukemia Research
- Health Sciences › Medicine › Internal Medicine › Amyloidosis: Diagnosis, Treatment, Outcomes
- Keywords
- monoclonal gammopathy of undetermined significance, prevalence, plasma cell dyscrasia, M protein, serum protein electrophoresis, immunofixation, age differences, Olmsted County, Minnesota
- MeSH terms
- Aged, Aged, 80 and over, Female, Humans, Immunoglobulin A, Immunoglobulin G, Immunoglobulin M, Male, Middle Aged, Minnesota, Paraproteinemias, Prevalence, Age Distribution, Sex Distribution
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