# Smouldering myeloma / MGUS

Source: https://onco.cc/terms/smoldering-myeloma/  
OnCo record `smoldering-myeloma` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Early plasma-cell conditions with no organ damage; most never progress, but high-risk smouldering disease is now sometimes treated.

## Summary

MGUS progresses at ~1% per year; smouldering myeloma at ~10% per year for five years, higher with the 20/2/20 criteria (M-protein >2 g/dL, >20% plasma cells, free light chain ratio >20). Lenalidomide (E3A06) and daratumumab (AQUILA, 2024: progression HR 0.49) delay progression in high-risk smouldering disease; whether to treat remains debated. iStopMM (Iceland) is screening a whole population.

## Fields

- Kind: Term
- Last checked: 2026-09-07
- Also known as: MGUS; monoclonal gammopathy; monoclonal gammopathy of undetermined significance; smouldering; smouldering myeloma; smoldering myeloma; smoldering; plasma cell dyscrasia; mgus-smouldering; Mayo 20/2/20; 20/2/20 criteria; IMWG 2/20/20 risk score; evolving M-protein; high-risk smouldering myeloma

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Monoclonal_gammopathy_of_undetermined_significance
- Wikipedia: https://en.wikipedia.org/wiki/Monoclonal_gammopathy_of_undetermined_significance

## Connected records

- terms: [Active surveillance and observation](https://onco.cc/terms/active-surveillance-term/), [Dysplasia (pre-cancerous change)](https://onco.cc/terms/dysplasia/), [M-protein, immunofixation and serum free light chains](https://onco.cc/terms/m-protein-free-light-chains/), [Tumour markers (CEA, LDH, chromogranin, thyroglobulin)](https://onco.cc/terms/tumour-markers/)
- technologies: [Active surveillance](https://onco.cc/technologies/active-surveillance/)
- cancers: [Multiple myeloma](https://onco.cc/cancers/multiple-myeloma/), [Smouldering multiple myeloma](https://onco.cc/cancers/smouldering-myeloma/)
- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/)
- drugs: [Daratumumab](https://onco.cc/drugs/daratumumab/), [Lenalidomide](https://onco.cc/drugs/lenalidomide/)
- trials: [iStopMM](https://onco.cc/trials/istopmm/)

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JSON: https://onco.cc/api/v1/entities/smoldering-myeloma.json