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theijcs.com The IJCS / Vol 1 / Issue 1

Smoldering multiple myeloma:To treat or not?

Dr M.Hussain Mir,
MD, DM, Post DM Fellowship BMT, AIIMS, New Delhi, Consultant Medical Oncologist.

Contributing Authors Affiliations:
N/A

Smoldering multiple myeloma (SMM) included in the spectrum of plasma cell disorders is an

asymptomatic clonal plasma cell disorder. It lies in between the monoclonal gammopathy of
undetermined significance (MGUS) and active multiple myeloma (MM). It is different from MGUS in

terms of a much higher risk of progression to multiple myeloma (MM) and from active multiple myeloma

it is distinguished in view of absence of symptoms which are clubbed together and known as myeloma
defining events and are coined as CRAB (Hypercalcemia,Renal failure,Anemia, Bone lesions). In

recent years there has been lot of progress in the diagnosis, prognosis, and management of SMM.

These include a revised disease definition, identification of several new prognostic factors, a
classification based on underlying cytogenetic changes, and new treatment options. Importantly, a

subset of patients previously considered SMM is now reclassified as MM on the basis of biomarkers

identifying patients with a more than 80% risk of progression within 2 years of diagnosis.

SMM has assumed greater significance on the basis of recent trials showing that early therapy

can be potentially beneficial to high risk patients. As a result, there is a need to accurately diagnose and
risk-stratify patients with SMM, including routine incorporation of modern imaging and laboratory

techniques.

Key Words: Multiple Myeloma, Smoldering Myeloma, Monoclonal gammopathy of

undetermined significance.

Corresponding Author
Dr M.Hussain Mir,
MD, DM, Post DM Fellowship BMT, AIIMS, New Delhi,
Consultant Medical Oncologist.

The Integrated Indian Journal of Cancer Sciences