@psue4 Welcome to Mayo Clinic Connect. As you read through the posts here, you will find that many people may be diagnosed with MGUS, but the vast majority live for a long time without any advancement of the disease into smoldering myeloma or beyond. In general, it is a "watch and wait" situation, with labwork every three to six months, following the results.

I am curious what aggressive treatment may have been suggested at the University hospital, and the reasons they gave for it?

Here is what Mayo Clinic has to say about MGUS: https://www.mayoclinic.org/diseases-conditions/mgus/symptoms-causes/syc-20352362
Ginger