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Prevalence of Monoclonal Gammopathy of Undetermined Significance
Open accessAbstract
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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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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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“In many instances MM is preceded by monoclonal gammopathy of undetermined significance (MGUS), a pre-malignant state without clinical symptoms of malignancy (1).”
BackgroundCurcumin for monoclonal gammopathies. What can we hope for, what should we fear?
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“3%, concerns a young population(2,4,24) with a median age of 41 years contrasting with MGUS in the general population, in which MG occurs generally after 60 years, although age differences are in part due to different age distributions of subjects in both populations.(25) Compared with our HIV cohort, the percentage o…”
BackgroundResultGeneration of a novel, multi-stage, progressive, and transplantable model of plasma cell neoplasms
Asai, T., Hatlen, M. A., Lossos, C., Ndiaye‐Lobry, D., DeBlasio, A., Murata, K., Fleisher, M., Cortizas, E. M., Verdún, R. E., Petrini, J. H. J., et al. (2016) · Scientific Reports · doi:10.1038/srep22760 · Cited by 5
Abnormal laboratory results: Screening for multiple myeloma
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“the general population, which does not favor a simple coincidence.[11,12] Nasr et al.”
BackgroundPlasma Cell Disorders in HIV Infected Patients: A Case Series
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“5% in those 85 years or older [62], which is particularly”
BackgroundCharacteristics and Outcomes of Eosinophilic Fasciitis–Associated Monoclonal Gammopathy
Mazori, D. R., Kassamali, B., Min, M. S., Schaefer, M., LaChance, A., Sperling, A. S., & Vleugels, R. A. (2021) · JAMA Dermatology · doi:10.1001/jamadermatol.2021.4302 · Cited by 5
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Self-citationDiagnosis and management of monoclonal gammopathy of clinical significance
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“The incidence of both MGUS and chronic kidney disease (CKD) increases with age [3, 14].”
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“5% of the population over 50 years of age with an average risk of progression to Multiple Myeloma (MM) or, to a lesser extent, to other lymphoproliferative disorders of 1% per year [2-4].”
BackgroundComparison of Fully Automated and Semiautomated Systems for Protein Immunofixation Electrophoresis
Napodano, C., Pocino, K., Gulli, F., Colacicco, L., Santini, S. A., Zuppi, C., & Basile, U. (2016) · Journal of Clinical Laboratory Analysis · doi:10.1002/jcla.22027 · Cited by 5
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BackgroundAn update on paraprotein-related renal pathology
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InfluentialHypoxic adaptation theory of cancer
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Active multiple myeloma suppresses and typically eliminates coexisting MGUS
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“MGUS progresses at a rate of 1% per year, and 3% of the population aging above 50 has MGUS (Dispenzieri et al. 2010; Kyle et al. 2002, 2006; Landgren et al. 2014; Therneau et al. 2012).”
Cicero, K. I., Dlamini, X., Mavengere, Y., Justman, J. E., Nuwagaba‐Biribonwoha, H., Dlamini, S., Dlamini, M., Ngwenyama, S., Ngcamphalala, C., Low, A., et al. (2024) · JNCI Cancer Spectrum · doi:10.1093/jncics/pkae056 · Cited by 4
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“[13] Kyle RA, Therneau TM, Rajkumar SV et al.”
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“3% in individuals <50 and 50 years old, respectively [8,9].”
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Ghosal, S., & Banerjee, S. (2022) · Medical Oncology · doi:10.1007/s12032-022-01651-w · Cited by 4
“MGUS occurs generally above 50 years of age in 3–5% of population [4].”
BackgroundChen, R., Jaye, D. L., Roback, J. D., Sherman, M. A., & Smith, G. H. (2022) · Journal of Pathology Informatics · doi:10.1016/j.jpi.2022.100128 · Cited by 4
Gammapatía monoclonal de significado incierto
Alejo, E., Puertas, B., & Mateos, M. (2023) · Medicina Clínica · doi:10.1016/j.medcli.2023.05.006 · Cited by 4
The Mechanisms of Telomere and Telomerase Regulation in Hematologic Malignancies
Kawauchi, K., Akiyama, M., & Yamada, O. (2013) · BENTHAM SCIENCE PUBLISHERS eBooks · doi:10.2174/9781608057986113010005 · Cited by 4
“Multiple myeloma (MM) is a clonal B-cell neoplasm characterized by the infiltration of atypical plasma cells into the bone marrow (BM) and associated with the presence of monoclonal protein in the serum or urine or both [262, 263].”
BackgroundAL amyloidosis: new drugs and tests, but old challenges.
Wechalekar, A. D., & Hawkins, P. N. (2012) · PubMed · Cited by 4
Osteoporosis Associated with Cancer Therapy
Heras-Herzig, A., Kozlow, W., Brown, S. A., & Guise, T. A. (2008) · Elsevier eBooks · doi:10.1016/b978-012370544-0.50056-2 · Cited by 4
Epidemiology of Multiple Myeloma
Ríos, R., Rodríguez, D. S., Chang-Chan, D. Y.-L., & Sánchez, M.-J. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.75396 · Cited by 4
“Several PD can progress to MM, such as MGUS [46], SMM [12] or solitary plasmacytoma [47].”
BackgroundInfluentialSečník, P., Jabor, A., Lavríková, P., Sečník, J., Malíková, P., Pokorná, E., & Franeková, J. (2019) · Transplant Immunology · doi:10.1016/j.trim.2019.101229 · Cited by 4
Renal Involvement in Systemic Amyloidosis Caused by Monoclonal Immunoglobulins
Karam, S., & Leung, N. (2020) · Hematology/Oncology Clinics of North America · doi:10.1016/j.hoc.2020.08.002 · Cited by 4
Hada, R., Poudyal, B. S., Sharma, A., & Khatri, R. (2012) · Journal of Nepal Medical Association · doi:10.31729/jnma.378 · Cited by 4
Jerez, A., Ortuño, F. J., Osma, M. D. M., Español, I., González, A. D., Roldán, V., de Arriba, F., & Vicente, V. (2009) · Annals of Medicine · doi:10.1080/07853890903111000 · Cited by 4
“Monoclonal gammopathy of undetermined significance (MGUS) is a plasma cell disorder found in approximately 3% of the general population 50 years of age or older (1).”
BackgroundLoctin, A., Bailly, F., Laroche, D., Tavernier, C., Maillefert, J.-F., & Ornetti, P. (2012) · Clinical Rheumatology · doi:10.1007/s10067-012-2097-y · Cited by 4
Transformation maligne des gammapathies monoclonales de signification indéterminée
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Classification of Plasma Cell Neoplasms
Yohe, S. L. (2015) · Springer eBooks · doi:10.1007/978-3-319-10918-3_4 · Cited by 4
“MGUS is the most common plasma cell disorder, being found in 3 % of individuals over age 50 and in greater than 5 % of individuals over age 70 [2–6].”
BackgroundMultiple myeloma: Vague symptoms can challenge diagnostic skills
Vickrey, E. (2008) · JAAPA · doi:10.1097/01720610-200811000-00005 · Cited by 4
Fouquet, G., Amouzou, K. S., Renaud, L., Carpentier, B., Simonnet, A., de Wyngaert, Z. V., Guidez, S., Demarquette, H., Seynave, M., Deleplanque, D., et al. (2014) · La Revue de Médecine Interne · doi:10.1016/j.revmed.2014.10.366 · Cited by 4
Tres casos de gammapatía monoclonal de significado renal postrasplante renal: nefropatía c3 de novo
Serra, N., Facundo, C., Canal, C., Arce, Y., Ayasreh, N., Vila, A., Bardají, B., Silva, I., López, V. A., Benito, S., et al. (2018) · Nefrología · doi:10.1016/j.nefro.2018.03.008 · Cited by 4
Wann sollte bei monoklonaler Gammopathie eine Nierenbiopsie erfolgen?
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Pathogenesis of Diabetic Neuropathies
Kelkar, S. (2020) · Springer eBooks · doi:10.1007/978-981-15-2417-2_3 · Cited by 4
Chennoufi, M., Boukhannous, I., Mokhtari, M., Moudane, A. E., Irzi, M., Ouraghi, A., Jandou, I., Miry, A., & Barki, A. (2021) · Case Reports in Urology · doi:10.1155/2021/6654437 · Cited by 4
“2% in the general population older than 50 years old [10].”
BackgroundMultiple Myeloma and Related Disorders
Rajkumar, S. V., & Dispenzieri, A. A. (2008) · Elsevier eBooks · doi:10.1016/b978-0-443-06694-8.50114-7 · Cited by 4
Self-citationClinical relevance of soluble HLA class I molecules in Waldenstrom Macroglobulinemia
Moreau, A., Sebti, Y., Duhamel, A., Roccaro, A. M., Coiteux, V., Gastinne, T., Friec, G. L., Burwick, N. R., Amiot, L., Ho, A. W., et al. (2008) · European Journal Of Haematology · doi:10.1111/j.1600-0609.2008.01060.x · Cited by 4
“IgM-MGUS displays at least 2-fold increase risk of progressing towards neoplasy, especially WM disease, compared to IgG and IgA-MGUS (29, 30).”
BackgroundCautions and caveats to the treatment of acquired hemophilia A
Huth‐Kühne, A., & (IPAcHe), O. B. O. T. I. E. P. O. A. H. (2009) · Haematologica · doi:10.3324/haematol.2009.011841 · Cited by 4
Vilarrasa, E., & Puig, L. (2014) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.12409 · Cited by 4
Racial disparities in multiple myeloma
Tebuka, E., Rambau, P., & Rasche, L. (2025) · Blood Global Hematology · doi:10.1016/j.bglo.2025.100017 · Cited by 3
Korbecki, J., Barczak, K., Bosiacka, B., Surówka, A., Duchnik, E., Skarbiński, M., Snarski, E., Chlubek, D., & Bosiacki, M. (2025) · Cancers · doi:10.3390/cancers17172888 · Cited by 3
Xin, X., Fan, C., Sheng, R., Li, X. C., Zhu, X., Huang, Y., Seraji, H. R., Urazbaeva, D., Atamuratova, Z., & Ubaydullaevna, A. D. (2026) · Clinical and Experimental Medicine · doi:10.1007/s10238-026-02050-5 · Cited by 4
“It is more frequent in men than women and in Afro-Caribbean compared with Caucasian populations [21 – 23 ].”
Deciphering epigenetic crosstalk in multiple myeloma pathogenesis and treatment
Alipoor, S. D., Shrestha, M., Liu, A., & Chang, H. (2026) · Clinical Epigenetics · doi:10.1186/s13148-026-02109-w · Cited by 3
“The development of MM follows a multistage process that begins with precursor conditions such as monoclonal gammopathy of undetermined significance (MGUS) [6], an asymptomatic premalignant plasma cell disorder characterized by elevated levels of defective immuno-globulins.”
Chronic inflammatory demyelinating polyneuropathy
Rajabally, Y. A., & Goedee, H. S. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-814572-2.00003-0 · Cited by 3
Fujimura, K., Sugiyama, A., Akita, T., Ohisa, M., Nagashima, S., Katayama, K., Maeda, R., & Tanaka, J. (2021) · International Journal of Hematology · doi:10.1007/s12185-020-03045-y · Cited by 3
“The most common immunoglobulin type in M-proteinemia in our study was IgG (66%), which was similar to findings in the American and French studies [19, 28].”
BackgroundResultInfluentialMeuleman, M.-S., Mouyabi, S., Gueguen, J., Vicca, S., Divard, G., Aubert, O., Bienaimé, F., Arnulf, B., Anglicheau, D., Bridoux, F., et al. (2023) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfad144 · Cited by 3
Screening for and diagnosis of monoclonal gammopathy
Chong, Y., Lim, S. M., Loh, T. P., Mollee, P. N., Wijeratne, N. G., & Choy, K. W. (2023) · Journal of Clinical Pathology · doi:10.1136/jcp-2023-208774 · Cited by 3
Developing a Library of Tree-Based Models for Survival Analysis
Vasilev, I. (2024) · Moscow University Computational Mathematics and Cybernetics · doi:10.3103/s0278641924700134 · Cited by 3
Musolino, A., Grifoni, G. F. A., Rodolfi, S., Andreasi, M., Bulgarelli, I., Fanelli, F., Morelli, V., Persani, L., & Campi, I. (2025) · Thyroid · doi:10.1177/10507256251364557 · Cited by 3
“25,27 Importantly, the identi fi cation of analytical interferences due to paraproteins can improve the patients ’ clinical management.”
Lauletta, A., Forcina, F., Merlonghi, G., Fionda, L., Leonardi, L., Costanzo, R., Tufano, L., Rossini, E., Marando, D., Vera, V., et al. (2025) · Autoimmunity Reviews · doi:10.1016/j.autrev.2025.103960 · Cited by 3
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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