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Purpose We previously reported the prevalence of monoclonal gammopathy of undeterminedsignificance (MGUS) to be 3.3% among an elderly Korean urban cohort recruited during2005-2006. Here, we report a 5-year follow-up study of the previously identified MGUScohort. Materials and MethodsThe 680 participants from the initial cohort were followed-up for a median of 5 years. Serawere collected between 2010 and 2011. Two-step screening was performed with standardserum electrophoresis followed by immunofixation and determination of the serumconcentration of monoclonal-protein (M-protein). ResultsOf the 680 participants (21 with MGUS), 348 (51%) agreed to participate in the follow-upstudy and 10 were found to have MGUS. Among the 21 MGUS patients initially identified,nine were followed-up, six had persistent M-protein, and one patient had progressed tomultiple myeloma (progression rate, 1.0%/yr). The M-protein disappeared in the remainingtwo individuals. Among the 339 participants without MGUS who were followed-up, fourdeveloped an M-protein. There was no significant difference in survival with respect to thepresence of MGUS (p=0.66). ConclusionThe 5-year follow-up data show that the natural clinical course of MGUS in Korea is similarto that in Western countries. MGUS was not associated with an increased risk of death overthe 5-year study period.

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