Bystander or perpetrator: Unravelling the significance and challenges of MGUS

Malini Surapaneni1, Jacob Edmisson1, Attaya Suvannasankha2

  • 1Indiana University Melvin and Bren Simon Comprehensive Cancer Center, 535 Barnhill Dr, Indianapolis, IN 46202, United States of America.

Blood Reviews
|February 8, 2026
PubMed

Insights

Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition. Further research is needed to refine risk prediction, understand disease biology, and develop early interventions for MGUS prevention.

Area of Science:

  • Hematology
  • Oncology
  • Translational Research

Background:

  • Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition.
  • MGUS is a known precursor to multiple myeloma.
  • Its role extends beyond myeloma precursor status.

Purpose of the Study:

  • To review unresolved controversies in MGUS management.
  • To explore population screening, risk stratification, pathogenic roles, and early intervention.
  • To identify knowledge gaps and future research directions.

Main Methods:

  • Literature review synthesizing emerging evidence.
  • Discussion of current limitations and future promises in MGUS research.
  • Focus on risk stratification, genomic tools, and therapeutic strategies.

Main Results:

  • MGUS offers opportunities for myeloma prevention.
  • Significant knowledge gaps persist in risk prediction and disease biology.
  • Current risk-stratification models have limitations.

Conclusions:

  • Effective MGUS management requires addressing key controversies.
  • Advanced biomarker discovery is crucial for defining optimal interventions.
  • Carefully designed clinical trials are essential for future progress.

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