 Monoclonal gammopathy of undetermined significance MGUS is an asymptomatic premalignant stage that almost always precedes multiple myeloma MM and amyloidosis. It is defined by a monoclonal-M-protein detected on serum protein electrophoresis or immunofixation electrophoresis and can be diagnosed with a blood sample. Approximately four percent of individuals 50 years or older have MGUS which is associated with a 1-2 annual risk of malignant transformation but it is impossible to predict which individuals diagnosed as having MGUS will progress and receive a diagnosis of malignant disease. 