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How we manage smoldering multiple myeloma.

Alessandra Romano1, Claudio Cerchione2, Concetta Conticello3

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|October 12, 2020
PubMed
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Smoldering myeloma (SMM) is an asymptomatic plasma cell disorder. This review updates clinical practices for high-risk SMM diagnosis, follow-up, and care, integrating new treatments and prognostic models.

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Smoldering multiple myeloma.

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Area of Science:

  • Hematology
  • Oncology
  • Clinical Practice Guidelines

Background:

  • Smoldering myeloma (SMM) is defined by 10-60% bone marrow plasma cells without myeloma-defining events or organ damage.
  • Previous prognostic models for SMM differed between Europe and the US.
  • Advances in novel therapies and prognostication necessitate updated clinical guidelines.

Purpose of the Study:

  • To review and update evidence on the clinical approach to SMM.
  • To provide a uniform view of diagnosis, follow-up, and supportive care for SMM.
  • To integrate recent advancements in SMM management, including novel drugs and prognostic tools.

Main Methods:

  • Literature review of recent studies and clinical trial data.
  • Analysis of current prognostic models and diagnostic criteria for SMM.
  • Synthesis of evidence presented in SOHO Italy discussions.

Main Results:

  • Novel drugs like lenalidomide and monoclonal antibodies offer high efficacy with limited toxicity.
  • Improved imaging and prognostication tools aid in identifying high-risk SMM.
  • There is a growing trend towards early treatment for high-risk SMM.

Conclusions:

  • Physicians face challenges in managing SMM due to evolving treatment options and criteria.
  • A unified approach to SMM diagnosis, follow-up, and supportive care is needed.
  • Early treatment considerations for high-risk SMM are increasingly important.