Patterns of progression in a contemporary cohort of 447 patients with smoldering multiple myeloma
Annika Werly, Mareike Hampel, Thomas Hielscher, Kosima Zuern, Sophia K. Schmidt, Alissa Visram, Marc S. Raab, Carsten Müller‐Tidow, Hartmut Goldschmidt, K. Elias
Abstract
Smoldering multiple myeloma (SMM) is considered an asymptomatic plasma cell disorder preceding multiple myeloma (MM). The course of SMM disease is heterogenous, largely driven by disease biology and tumor burden [ 1 , 2 ]. Routine clinical surveillance or early treatment, mostly within clinical trials, is thus based on the likelihood of developing a myeloma defining event (MDE) requiring systemic treatment [ 3 ]. Current stratification models for risk of progression include bone marrow plasma cell (BMPC) infiltration, monoclonal (M) protein component, ratio of involved/uninvolved serum free light chains (FLCr), and cytogenetic abnormalities [ 4 , 5 ]. Early systemic treatment of high-risk SMM has shown to improve progression free survival in two trials and overall survival (OS) in one of them [ 6 , 7 ]. However, early treatment of SMM is not considered a standard of care [ 8 , 9 ].