Risk factors for monoclonal gammopathy of undetermined significance: a systematic review

UMMS Affiliation

Department of Population and Quantitative Health Sciences; Meyers Primary Care Institute; Department of Medicine; Graduate School of Biomedical Sciences

Publication Date


Document Type



Clinical Epidemiology | Epidemiology | Health Services Research | Hematology | Hemic and Immune Systems | Hemic and Lymphatic Diseases | Immune System Diseases


Monoclonal gammopathy of undetermined significance (MGUS), precursor of multiple myeloma, is an asymptomatic plasma cell disorder that overproduces serum monoclonal protein. Older age, male sex, black race, and family history of MGUS increase the risk of MGUS, yet other risk factors are known. We systematically reviewed observational epidemiological studies that examined sociodemographic, clinical, and behavioral risk factors for the development of MGUS. The protocol for this study was registered on the PROSPERO registry for systematic reviews. We identified epidemiological studies from PubMed and Scopus. Articles were limited to those written in English and published before February 2019. Five case-control and three cohort studies were eligible for data extraction. Studies evaluating factors associated with MGUS risk are limited, with conflicting conclusions regarding risk associated with obesity. Despite the limited research, a significant elevated risk for being diagnosed with MGUS was associated with several specific prior infections, inflammatory disorders, and smoking. The sparse existing literature suggests an increased risk of MGUS associated with several risk factors related to immune function. Further research is needed to explore the potential mechanisms underlying the development of MGUS and to confirm risk factors, both modifiable and non-modifiable.


Monoclonal gammopathy of undetermined significance, MGUS, Risk factors, Systematic review

DOI of Published Version



Castaneda-Avila MA, Ulbricht CM, Epstein MM. Risk factors for monoclonal gammopathy of undetermined significance: a systematic review. Ann Hematol. 2021 Jan 8. doi: 10.1007/s00277-021-04400-7. Epub ahead of print. PMID: 33416902. Link to article on publisher's site

Journal/Book/Conference Title

Annals of hematology

PubMed ID


Related Resources

Link to Article in PubMed