Onkológia 2/2016

Smoldering multiple myeloma

Smoldering multiple myeloma is a heterogeneous clinical entity where a subset of patients has an indolent course of disease that mimics monoclonal gammopathy of undetermined significance, whereas others have a more aggressive course that has been described as „early myeloma“. There are currently no molecular factors to differentiate risks of progression for these patients. Current recommendations of therapy continue to be patient observation or patient enrolment in clinical trials. However, new definitions of active multiple myeloma recently agreed upon by the international Myeloma Working Group may alter the timing of therapy. On the basis of emerging data of therapy in these patients, it seems reasonable to believe that future recommendations for therapy of patients with smoldering myeloma will become an increasingly important topic. In this article, we review the current knowledge of this disease and risk factors associated with progression. We also review clinical trials that have been performed in these patients and provide recommendations for follow-up of patients with this unique disease entity.

Keywords: smoldering multiple myeloma, prognosis, risk-stratification, treatment of high-risk and low-risk SMM