Multiple Myeloma Support Group

Again Ive received a number of questions so I wanted to add some comments on Smoldering Multiple Myeloma (SMM). This is detailed so hang in there.


1) Smoldering Multiple Myeloma (a different entity than MGUS and MM) carries the risk of progression to MM of 10-20% per year
2) The diagnosis of SMM requires a serum M protein 3 g/dL or bone marrow plasma cells 10% AND THE ABSENCE OF anemia, hypercalcemia, lytic bone lesions, or renal failure

3) WHAT ARE RISK FACTORS FOR PROGRESSION of SMM to MM?
The size and type of immunoglobulin are important predictors of progression according to recent studies: Patients with a serum M protein 3 gm/dL and IgG type (comprising about 45% of patients) had a median time to progression of over 4 years. Patients with either serum M protein > 3 gm/dL or IgA type (about 45% of patients) had a median Time to Progression of approximately 2 years, while a small subset of patients with > 3 gm/dL IgA SMM had a median time to progression of 9 months.
Additionally the presence of occult bone lesions on MRI magnetic resonance imaging greatly increases the risk of progression to symptomatic MM.

4) What is the management of SMM? Close follow up with visit every 3-4 months and an annual skeletal survey is recommended. CURRENTLY THERE IS NO EVIDENCE that early treatment of SMM prevents progression to MM.

Hope this helps
Dr O.
Posted on 12/05/07, 05:12 pm