• Definition
    • Asymptomatic premalignant plasma cell disorder.
    • Presence of a monoclonal protein (M protein) without features of multiple myeloma.
  • Almost always asymptomatic.
  • Diagnostic Criteria
    • Serum M protein < 3 g/dL
    • Bone marrow clonal plasma cells < 10%
    • No end-organ damage (No CRAB criteria: hyperCalcemia, Renal insufficiency, Anemia, Bone lesions)
  • Prognosis & Management
    • Risk of progression to Multiple Myeloma: ~1% per year.
    • Tx: Observation with serial monitoring (e.g., SPEP every 6-12 months).