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Updated: Jun 10, 2026

Multimodal Bioluminescent and Positronic-emission Tomography/Computational Tomography Imaging of Multiple Myeloma Bone Marrow Xenografts in NOG Mice
05:32

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Smoldering (asymptomatic) multiple myeloma: revisiting the clinical dilemma and looking into the future

Adam J Waxman1, Michael Kuehl, Arun Balakumaran

  • 1Medical Oncology Branch, National Cancer Institute, Bethesda, MD, USA.

Clinical Lymphoma, Myeloma & Leukemia
|August 17, 2010
PubMed

Insights

Smoldering multiple myeloma (SMM) is a precursor to multiple myeloma (MM). Current monitoring strategies are insufficient due to SMM's molecular heterogeneity, necessitating research into novel biomarkers for early intervention.

Area of Science:

  • Hematology
  • Oncology
  • Molecular Biology

Background:

  • Multiple myeloma (MM) often arises from an asymptomatic precursor state, smoldering multiple myeloma (SMM).
  • SMM is characterized by specific M-protein levels or bone marrow plasma cell percentages without end-organ damage.
  • SMM patients have a significantly higher risk of progression to MM compared to those with monoclonal gammopathy of undetermined significance (MGUS).

Purpose of the Study:

  • To review novel biomarkers, molecular profiles, and microenvironmental interactions in myelomagenesis.
  • To explore the potential for integrating new biologic markers with clinical monitoring for early treatment strategies in high-risk SMM.

Main Methods:

  • Review of recent studies on SMM and multiple myeloma.
  • Analysis of molecular heterogeneity and current clinical markers for SMM risk stratification.
  • Discussion of emerging biomarkers and therapeutic strategies.

Main Results:

  • SMM exhibits significant molecular heterogeneity, limiting current prognostic markers.
  • Existing clinical markers stratify SMM into three risk groups, but individual prediction remains challenging.
  • Recent advancements offer potent drugs for potential early MM treatment strategies.

Conclusions:

  • Effective prediction of individual SMM patient prognosis is currently lacking due to molecular heterogeneity.
  • Current guidelines recommend close monitoring and treatment upon progression to symptomatic MM.
  • Integrating novel biomarkers and clinical monitoring may enable early treatment for high-risk SMM patients.

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