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Updated: Apr 12, 2026

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Smoldering multiple myeloma.

Minjie Gao1, Guang Yang1, Yuanyuan Kong1

  • 1Department of Hematology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.

Biomed Research International
|May 23, 2015
PubMed
Summary
This summary is machine-generated.

Smoldering multiple myeloma (SMM) is a precursor to multiple myeloma (MM). Early treatment with lenalidomide plus dexamethasone may benefit high-risk SMM patients, prompting reevaluation of current treatment guidelines.

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Area of Science:

  • Hematology
  • Oncology
  • Clinical Research

Background:

  • Smoldering multiple myeloma (SMM) is an asymptomatic stage preceding multiple myeloma (MM).
  • It is characterized by specific bone marrow plasma cell percentages or M protein levels without end-organ damage.
  • SMM lies between monoclonal gammopathy of undetermined significance (MGUS) and symptomatic MM.

Purpose of the Study:

  • To review risk stratification parameters for SMM progression.
  • To discuss the implications of recent trials on early treatment for high-risk SMM.
  • To reevaluate the current non-treatment approach for SMM.

Main Methods:

  • Review of established risk factors for SMM progression.
  • Analysis of clinical trial data, specifically the Mateos et al. trial.
  • Discussion of immunophenotypic, serologic, and imaging markers.

Main Results:

  • Multiple factors predict SMM progression risk, including M protein level, bone marrow plasma cells, free light-chain ratio, and cytogenetics.
  • The Mateos et al. trial demonstrated a survival benefit with early lenalidomide plus dexamethasone in high-risk SMM.
  • This finding challenges the traditional approach of no early treatment for SMM.

Conclusions:

  • Risk stratification in SMM is crucial for identifying patients who may benefit from early intervention.
  • Early treatment with lenalidomide plus dexamethasone shows promise for high-risk SMM patients.
  • Further research is warranted to refine treatment strategies for SMM.