When does smoldering myeloma require treatment?

Treatment is indicated when any CRAB criteria appear (hyperCalcemia, Renal impairment, Anemia, Bone lesions) or biomarkers of malignancy: bone marrow plasma cells 60% or above, serum involved/uninvolved FLC ratio 100 or above, or more than one focal lesion on MRI.

What is the risk of SMM progressing to MM?

Overall 5-year risk is approximately 50%, but high-risk SMM (2 or 3 of: M-protein 2 g/dL+, BM plasma cells 20%+, FLC ratio 20+) has 2-year progression rate over 70%. Low-risk SMM progression risk is under 10% at 5 years.

Plasma Cell Percent to Smoldering Myeloma Criteria

Apply criteria to distinguish smoldering multiple myeloma (serum M-protein 3 g/dL or above, or bone marrow plasma cells 10–60%) from MGUS and symptomatic MM requiring treatment.

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ISS Myeloma Staging

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MGUS Progression Risk

Medical Long-tail

Plasma Cell Percent to Smoldering Myeloma Criteria

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Frequently Asked Questions

When does smoldering myeloma require treatment?

What is the risk of SMM progressing to MM?