Fig. 1

MGUS (low risk vs. other MGUS at first pre-diagnostic blood draw) progressing to myeloma. A Overall survival since myeloma diagnosis. Hazard ratios (HRs) and 95% confidence intervals (CIs) for death adjusted for sex, age at diagnosis (continuous), time of diagnosis (continuous), Eastern Cooperative Oncology Group (ECOG) performance status (ECOG 0 or 1 vs. ECOG 2 or 3), International Staging System (ISS) stage (ISS-1 vs. ISS-2 or ISS-3), the proportion of clonal bone marrow plasma cells (continuous), lactate dehydrogenase levels (normal vs. elevated), disease status at myeloma diagnosis (smoldering multiple myeloma [SMM] vs. multiple myeloma [MM]), and immunoglobulin (Ig) isotype (IgG vs. non-IgG vs. light-chain). B Overall survival since frontline therapy start excluding five patients who did not progress to MM. HRs and 95% CIs for death adjusted for sex, age at diagnosis (continuous), time of diagnosis (continuous), performance status (ECOG 0 or 1 vs. ECOG 2 or 3), ISS stage (ISS-1 vs. ISS-2 or ISS-3), the proportion of clonal bone marrow plasma cells (continuous), lactate dehydrogenase levels (normal vs. elevated), isotype (IgG vs. non-IgG vs. light-chain), and treatment details (autologous stem cell transplant [ASCT] vs. no ASCT; proteasome inhibitor [PI] and immunomodulating drug [IMiD] vs. PI or IMiD vs. no modern drug; modern drug in frontline treatment vs. not). C, D M spike trajectories in patients who had low-risk MGUS (N = 12) and other MGUS of IgG isotype (N = 15) at first pre-diagnostic blood draw (for better comparison restricted to IgG isotype). M spike concentrations are plotted for each individual at the time point of first and at repeated pre-diagnostic blood draw, at myeloma diagnosis (which is indicated by the time point 0), and at MM initiation (i.e. frontline therapy start) or the time of last clinical follow-up in four individuals who did not progress to MM