Genomic and Psychosocial Effects of the 3RP on Patients With MGUS and Smoldering Multiple Myeloma

Inclusion Criteria:

* Participants must have confirmed high-risk monoclonal gammopathy of undetermined significance (MGUS) or smoldering multiple myeloma (SMM) as defined below in table #.

MGUS

* Serum monoclonal protein level \< 3 g/dL but \> 1.5g/dl,
* Bone marrow plasma cells \< 10%
* Non-IgG MGUS (ie IgA, IgM, IgD MGUS)
* Abnormal serum free light chain ratio (ie ratio of kappt to lambda free light chains \< 0.26 or \> 1.65)
* Absence of end-organ damage, such as lytic bone lesions, anemia, hypercalcemia, or renal failure, that can be attributed to a plasma cell proliferative disorder

SMM (also referred to as asymptomatic multiple myeloma)

* Serum monoclonal protein (IgG or IgA) level \> 3 g/dL,
* and /or bone marrow plasma cells \> 10%,
* absence of end-organ damage, such as lytic bone lesions, anemia, hypercalcemia, or renal failure, that can be attributed to a plasma cell proliferative disorder
* Participants must be at least 18 years old. Because no dosing or adverse event data are currently available on the use of RR in participants \<18 years of age, children are excluded from this study.
* The effects of RR on the developing human fetus are unknown. For this reason, should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
* Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

* Participants who exhibit any of the following conditions at screening will not be eligible for admission into the study.
* Participants with concurrent active cancer or active cancer with in the last 5 years are ineligible.
* Participants with serious or unstable illness, as determined by study physicians and clinicians, may be deemed unfit to participate.
* Participants with current bipolar or psychotic disorders with active symptoms or treatment within the last 5 year will be excluded.
* Participants will be excluded if they are currently taking (within the last 6 months) psychoactive medications (e.g. mood stabilizers, antipsychotics), with the exception of hypnotics and antidepressants, which will be permitted.
* Participants may not be receiving any other study agents.