Diagnosis and management of smoldering multiple myeloma: the razor's edge between clonality and cancer

Leuk Lymphoma. 2018 Feb;59(2):288-299. doi: 10.1080/10428194.2017.1334124. Epub 2017 Jun 8.

Abstract

Smoldering multiple myeloma (SMM) is a rare plasma cell disorder, and as the disease is asymptomatic, diagnosis is often incidental. SMM is characterized by increased marrow infiltration by clonal plasma cells and/or elevated serum M-protein in the absence of a myeloma-defining event (MDE). In recent years, SMM has gained increased attention owing to a broadening of the criteria for MDE, which include apart from the CRAB criteria, three additional parameters. Survival advantage may be offered by early treatment in the high-risk subset, based on a single trial. In this review, we assess the risk factors and models for progression to multiple myeloma. A review of our diagnostic and management approaches to SMM is presented.

Keywords: Risk; early intervention; models; progression; survival.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Clonal Evolution / genetics
  • Combined Modality Therapy
  • Diagnostic Imaging / methods
  • Disease Management
  • Disease Progression
  • Humans
  • Molecular Diagnostic Techniques
  • Plasma Cells / metabolism
  • Plasma Cells / pathology
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Smoldering Multiple Myeloma / diagnosis*
  • Smoldering Multiple Myeloma / etiology
  • Smoldering Multiple Myeloma / therapy*
  • Treatment Outcome

Substances

  • Biomarkers