Clinical Course and Prognosis of Smoldering (Asymptomatic) Multiple Myeloma

• Published in: The New England journal of medicine Vol. 356; no. 25; pp. 2582 - 2590
• Main Authors: Kyle, Robert A, Remstein, Ellen D, Therneau, Terry M, Dispenzieri, Angela, Kurtin, Paul J, Hodnefield, Janice M, Larson, Dirk R, Plevak, Matthew F, Jelinek, Diane F, Fonseca, Rafael, Melton, Lee Joseph, Rajkumar, S. Vincent
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 21.06.2007
• Subjects: Adult; Aged; Aged, 80 and over; Amyloidosis; Antibodies, Monoclonal - blood; Biological and medical sciences; Biopsy; Bone marrow; Bone Marrow Cells - immunology; Bone Marrow Cells - pathology; Bone Marrow Examination; Cellulose acetate; Cohort Studies; Disease Progression; Estimates; Female; General aspects; Humans; Immunodeficiencies. Immunoglobulinopathies; Immunoglobulinopathies; Immunopathology; Lymphocyte Count; Male; Medical sciences; Middle Aged; Multiple Myeloma - blood; Multiple Myeloma - immunology; Multiple Myeloma - pathology; Plasma Cells; Prognosis; Proteins; Risk Factors; Transplants & implants; Medicine; Immunopathology; Prognosis; Immunoglobulinopathy; Lymphoproliferative syndrome; Evolution; Malignant hemopathy; Asymptomatic; Myeloma
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa070389

In this study, the risk of progression of asymptomatic smoldering multiple myeloma to active multiple myeloma was found to be related to the level of serum monoclonal immunoglobulin and the proportion of plasma cells in the bone marrow at the time of diagnosis. The risk of progression of smoldering multiple myeloma to active multiple myeloma was found to be related to the level of serum monoclonal immunoglobulin and the proportion of plasma cells in the bone marrow at the time of diagnosis. Smoldering multiple myeloma is an asymptomatic proliferative disorder of plasma cells with a high risk of progression to symptomatic, or active, multiple myeloma. Previous studies have used various definitions of the disease, and this variability has resulted in important differences in the reported clinical course of the disease. 1 – 7 International consensus criteria for smoldering multiple myeloma were adopted recently to rectify this problem. 8 We report here on the prognosis and risk factors for progression of smoldering multiple myeloma in a large cohort of patients for whom long-term follow-up data were available and in whom the disease was defined with the . . .