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IgG and IgA <jats:styled-content style=\"fixed-case\">MGUS<\/jats:styled-content> are precursor conditions of multiple myeloma (<jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>), whereas light\u2010chain <jats:styled-content style=\"fixed-case\">MGUS<\/jats:styled-content> is a precursor condition of light\u2010chain <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>. Smoldering <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">SMM<\/jats:styled-content>) is a precursor condition with higher tumor burden and higher risk of progression to symptomatic <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> compared to <jats:styled-content style=\"fixed-case\">MGUS<\/jats:styled-content>. Assessment of the risk of progression of patients with asymptomatic monoclonal gammopathies is based on various factors including clonal burden, as well as biological characteristics, such as cytogenetic abnormalities and light\u2010chain production. Several models have been constructed that are useful in daily practice for predicting risk of progression of <jats:styled-content style=\"fixed-case\">MGUS<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">SMM<\/jats:styled-content>. Importantly, the plasma cell clone may occasionally be responsible for severe organ damage through the production of a M\u2010protein which deposits in tissues or has autoantibody activity. These disorders are rare and often require therapy directed at eradication of the underlying clone. Importantly, recent studies have shown that asymptomatic patients with a bone marrow plasma cell percentage \u226560%, free light\u2010chain ratio \u2265100, or &gt;1 focal lesion on <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> (myeloma\u2010defining events) have a 80% risk of developing symptomatic <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> within 2\u00a0years. These patients are now considered to have <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> requiring therapy, similar to patients with symptomatic disease. In this review, we provide an overview of the new diagnostic criteria of the monoclonal gammopathies and discuss risk of progression to active <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>. We also provide recommendations for the management of patients with <jats:styled-content style=\"fixed-case\">MGUS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">SMM<\/jats:styled-content> including risk\u2010adapted follow\u2010up.<\/jats:p>","DOI":"10.1111\/ijlh.12504","type":"journal-article","created":{"date-parts":[[2016,5,10]],"date-time":"2016-05-10T04:06:58Z","timestamp":1462853218000},"page":"110-122","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Diagnosis, risk stratification and management of monoclonal gammopathy of undetermined significance and smoldering multiple myeloma"],"prefix":"10.1111","volume":"38","author":[{"given":"N. W. C. 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