Smoldering multiple myeloma and monoclonal gammopathy of undetermined significance.

Current Treatment Options in Oncology
Joan Bladé, Laura Rosiñol

Abstract

Smoldering multiple myeloma (SMM) consists of the presence of a serum M protein of 30 g/L or more and/or 10% or more bone marrow plasma cells (BMPCs), with no clinical manifestations or symptoms of myeloma. It accounts for approximately 10% of all myelomas, and the median time to progression to a symptomatic multiple myeloma ranges from 2 to 3 years. The main factors for progression are the plasma cell mass (M-protein size and percent of BMPCs), the spinal MRI pattern, the plasma cell proliferative index, and the variant of SMM ("evolving" vs "nonevolving"). Although treatment with thalidomide is promising (based on the results of two phase II trials), outside the context of a clinical trial, a watch-and-wait approach with clinical evaluation every 4 months is recommended until evident symptomatic disease progression occurs. Patients with monoclonal gammopathy of undetermined significance (MGUS) have a serum M protein lower than 30 g/L and a proportion of BMPCs of less than 10%, with no clinical findings or symptoms attributable to the monoclonal gammopathy. MGUS has a high prevalence, and its annual rate of malignant transformation is 1%, such that the actuarial probability of progression to a symptomatic monoclonal gammopathy...Continue Reading

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Citations

Dec 29, 2006·The New England Journal of Medicine·Joan Bladé
Dec 23, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Joan BladéRobert A Kyle
Jan 15, 2011·Seminars in Hematology·Esther MenaKaren Kurdziel
Jan 16, 2008·Physical Medicine and Rehabilitation Clinics of North America·Charlene Hoffman-Snyder, Benn E Smith
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Aug 18, 2010·Mayo Clinic Proceedings·Rishi K Wadhera, S Vincent Rajkumar
Jul 13, 2019·British Journal of Haematology·Prashant Kapoor
Jul 5, 2011·The Journal of the American Academy of Orthopaedic Surgeons·Thomas J ScharschmidtErnest U Conrad

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