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Smoldering multiple myeloma: prevalence and current evidence guiding treatment decisions

Authors Blum A, Bazou D, O'Gorman P

Received 4 October 2017

Accepted for publication 2 December 2017

Published 20 April 2018 Volume 2018:8 Pages 21—31

DOI https://doi.org/10.2147/BLCTT.S136447

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor David Dingli


Agnieszka Blum, Despina Bazou, Peter O’Gorman

Department of Hematology, Mater Misericordiae University Hospital, Dublin, UK

Abstract: Smoldering multiple myeloma (SMM) is an asymptomatic plasma cell proliferative disorder associated with risk of progression to symptomatic multiple myeloma (MM) or amyloidosis. In comparison to monoclonal gammopathy of undetermined significance (MGUS), SMM has a much higher risk of progression to MM. Thanks to advances in our understanding of the risk factors, the subset of patients with ultra-high risk of progression to MM (80%–90% at 2 years) has been identified. The revision of the diagnostic criteria resulted in changes in the management of this cohort of patients. In contrast to the management guidelines for MGUS patients, SMM patients need to be studied more intensively in order to identify biomarkers necessary for accurate risk stratification. In this review, we focus on the risk of progression from SMM to MM, as well as the influence of early treatment on overall survival, time to progression and quality of life.

Keywords: smoldering multiple myeloma, risk factor, biomarker, genomic aberrations, glycan analysis

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