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Current clinical guidelines report that MGUS's rate of malignant progression to haematological malignancy (HM) is ~1% per year; however, reported rates have varied widely. To address this discrepancy, a systematic review was conducted, investigating MGUS's rate of malignant progression to HM and MM alone. Four electronic databases were searched from inception to 28 March 2024 for articles reporting these outcomes; articles were summarised using meta\u2010analysis and narrative synthesis. Findings were incorporated from\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200946 studies, published between 1991 and 2024 and conducted across\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200917 countries. Median follow\u2010up ranged from 1.3 to 34.2\u2009years and sample sizes ranged from\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200963 to 17,963. In random\u2010effects meta\u2010analysis,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200913 studies reported on MGUS progression to HM and\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200912 reported on progression to MM. The overall estimates of malignant progression events were 12 per 1000 person\u2010years to HM, equivalent to 1.2% per year (95% CI: 1.0%\u20131.5%) and 8 per 1000 person\u2010years to MM or 0.8% per year (95% CI: 0.7%\u20131.1%), with substantial heterogeneity between studies (\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    : 96.7% and 95.8%, respectively). Progression rates varied widely in narrative synthesis; at 10\u2009years, studies reported annual MGUS progression rates of 6.6%\u201333.6% to HM and 7.0%\u201328.5% to MM. While progression rates aligned with clinical guidelines overall, studies' varied findings present opportunities for further research, exploring the impact of world region, follow\u2010up duration, and study methods. Considering this, caution should be taken when informing clinicians and patients about the risk of progression from MGUS to MM.\n                  <\/jats:p>","DOI":"10.1111\/ejh.70086","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:38:14Z","timestamp":1772984294000},"page":"889-906","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Rate of\n                    <scp>MGUS<\/scp>\n                    Progression to Haematological Malignancies: A Systematic Review"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1671-9947","authenticated-orcid":false,"given":"Stephen James","family":"Quinn","sequence":"first","affiliation":[{"name":"Centre for Public Health Queen's University Belfast  Belfast Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Cardwell","sequence":"additional","affiliation":[{"name":"Centre for Public Health Queen's University Belfast  Belfast Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley Ann","family":"Anderson","sequence":"additional","affiliation":[{"name":"Biostatistics &amp; Health Data Science, Institute of Applied Health Sciences University of Aberdeen  Aberdeen Scotland"},{"name":"Interdisciplinary Institute, Vice Principals Office University of Aberdeen  Aberdeen Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlene","family":"McShane","sequence":"additional","affiliation":[{"name":"Centre for Public Health Queen's University Belfast  Belfast Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2005.1.340"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102008\u201012\u2010194241"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2010.60"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19957"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0337"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277\u2010021\u201004400\u20107"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102021\u2010152333"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa01133202"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.4065\/79.7.859"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102141.2008.07423.x"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0755-4982(06)74771-6"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102003\u201003\u20100801"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(14)70442\u20105"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa01133202"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2012.189"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201019\u20100132"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.4065\/82.4.428"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102007\u201005\u2010088443"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010158\u20104\u2010201302190\u201000009"},{"key":"e_1_2_13_22_1","volume-title":"Newcastle\u2010Ottawa Quality Assessment Scale Cohort Studies","author":"Wells G.","year":"2014"},{"key":"e_1_2_13_23_1","unstructured":"National Institutes of Health \u201cNational Institutes of Health Quality Assessment Tool for Observational Cohort and Cross\u2010Sectional Studies \u201d2016 accessed August 22 2023 https:\/\/www.nhlbi.nih.gov\/health\u2010pro\/guidelines\/in\u2010develop\/cardiovascular\u2010risk\u2010reduction\/tools\/cohort."},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.12885"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12666"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197\u20102456(86)90046\u20102"},{"key":"e_1_2_13_27_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.2","author":"Higgins J.","year":"2021"},{"issue":"3","key":"e_1_2_13_28_1","first-page":"303","article-title":"Retrospective Analysis of Progression to Multiple Myeloma or Related Disorders in 114 Patients With Monoclonal Gammopathy of Undetermined Significance in a Single Institute","volume":"53","author":"Yokota S.","year":"2012","journal-title":"Rinsh\u014d Ketsueki"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0308\u20102261(21)00319\u20102"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102141.2003.04355.x"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.3816\/CLM.2009.n.002"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.239632"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201097664\u2010y"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S255390"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010021\u201001454\u20104"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003193"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1515\/CCLM.2007.029"},{"key":"e_1_2_13_39_1","article-title":"Gammapat\u00edas Monoclonales de Significado Indeterminado. 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