Smoldering multiple myeloma: Reviewing the rationale for intervention

Abstract

Smoldering multiple myeloma has been recognized for over 40 years and represents a pre-symptomatic phase of the 2nd most common hematologic malignancy. 1/3 of patients will remain asymptomatic at 10 years. There is an identifiable subset of patients that will develop CRAB within 2 years of recognition and these patients are considered for therapeutic intervention before the development of potentially irreversible complications. Obstacles to widespread implementation of therapeutic guidelines are limited by the variable definitions associated with this high-risk group as well as the poor concordance between classification schemes. Analysis of clinical trial outcomes as well as uniform eligibility helps determine whether a given patient should be considered for therapeutic intervention outside of a clinical trial.

Keywords:

• Monoclonal gammopathy undetermined significance
• multiple myeloma
• smoldering multiple myeloma
• myeloma defining events
• chemoprevention

Disclosure statement

Reports personal fees from Ionis/Akcea, personal fees from Prothena, personal fees from Sanofi, personal fees from Janssen, personal fees from Aptitude Healthgrants and personal fees from Ashfield Meetings personal fees from Juno, personal fees from Physicians Education Resource, personal fees for Data Safety Monitoring board from Abbvie, fees from Johnson & Johnson,and Celgene, personal fees from Research to Practice, Meetings personal fees from Sorrento, Development of educational materials for i3Health.

Additional information

Funding

NCI SPORE MM SPORE 5P50 CA186781-04.