• No treatment; long term follow-up with review of clinical and laboratory features required due to risk of progression.

• Clinical and laboratory (FBC, PV, renal function, serum Ca2+, serum Igs, paraprotein quantitation and urine electrophoresis) re-evaluation at 3 months then 6 months then annually.

• Where diagnosis in doubt (e.g. elderly woman with paraprotein <30g/L and osteoporosis) review over 3-6 months usually differentiates MGUS from MM.

• Advise patients to seek early assessment if unexplained symptoms develop.

Kyle, R.A. (1997) Monoclonal gammopathy of undetermined significance and solitary plasmacytoma. Implications for progression to overt multiple myeloma. Hematol Oncol Clin North Am, 11,

71-87; Kyle, R.A. et al. (2002) A long-term study of prognosis in monoclonal gammopathy of undetermined significance. N Engl J Med, 346, 564-569.

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