In clinical practice, most patients with monoclonal gammopathy of undetermined significance (MGUS) undergo long-term follow-up without disease progression. There is insufficient real-world data about how closely and whether anything other than disease progression should be monitored. Herein, we performed a nationwide study of 470 patients with MGUS with a 10-year follow-up to determine the patterns of disease progression and other comorbidities. During the follow-up period, 158 of 470 patients with MGUS (33.62%) progressed to symptomatic monoclonal gammopathies. Most of these were multiple myeloma (134/470 patients, 28.51%), and those diagnosed within 2 years after diagnosis of MGUS was high. Approximately 30–50% of patients with MGUS had hypertension, diabetes, hyperlipidemia, and osteoarthritis at the time of diagnosis, and these comorbidities were newly developed during the follow-up period in approximately 50% of the remaining patients with MGUS. Approximately 20–40% of patients with MGUS have acute or chronic kidney failure, thyroid disorders, disc disorders, peripheral neuropathy, myocardial infarction, stroke, and heart failure during the follow-up period. Altogether, when MGUS is diagnosed, close follow-up of the possibility of progression to multiple myeloma is required, especially within 2 years after diagnosis; simultaneously, various comorbidities should be considered and monitored during the follow-up of patients with MGUS. Continuous research is needed to establish appropriate follow-up guidelines.

在临床实践中，大多数患有意义未明的单克隆丙种球蛋白病（MGUS）的患者经过长期随访，没有出现疾病进展。关于如何密切监测以及是否应监测疾病进展以外的其他因素，目前还没有足够的真实数据。在此，我们对 470 名 MGUS 患者进行了一项全国性研究，并进行了 10 年随访，以确定疾病进展和其他合并症的模式。在随访期间，470 名 MGUS 患者中有 158 名（33.62%）进展为有症状的单克隆丙种球蛋白病。其中大多数为多发性骨髓瘤（134/470例，28.51%），且MGUS诊断后2年内确诊的比例较高。大约 30-50% 的 MGUS 患者在诊断时患有高血压、糖尿病、高脂血症和骨关节炎，而这些合并症是在随访期间约 50% 的其余 MGUS 患者新出现的。大约 20-40% 的 MGUS 患者在随访期间出现急性或慢性肾衰竭、甲状腺疾病、椎间盘疾病、周围神经病变、心肌梗死、中风和心力衰竭。总而言之，当确诊 MGUS 后，需要密切随访，了解进展为多发性骨髓瘤的可能性，尤其是诊断后 2 年内；同时，在 MGUS 患者的随访过程中应考虑和监测各种合并症。需要持续研究来建立适当的后续指南。