The incidental monoclonal protein: current approach to management of monoclonal gammopathy of undetermined significance (MGUS).

'Monoclonal gammopathy of undetermined significance' (MGUS) is a pre-malignant disorder characterized by limited clonal proliferation of the bone marrow plasma cells without any evidence of end-organ damage. A better understanding of the prevalence rates, natural history, and the risk factors for progression of MGUS, provides further insight into the clinical approach to management of this condition. The clinical implications of MGUS such as the risk of fracture, miscellaneous conditions associated with a monoclonal M-protein, and a practical approach to the management of MGUS patients based on a risk-stratification model are discussed in this review.