Smoldering Multiple Myeloma

An asymptomatic and slow-growing PLASMA CELL dyscrasia characterized by presence of MYELOMA PROTEINS and clonal bone marrow plasma cells without end-organ damage (e.g., renal impairment). It is distinguished from MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE by a much higher risk of progression to symptomatic MULTIPLE MYELOMA.

Also Known As:

Networked: 215 relevant articles (15 outcomes, 30 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Multiple Myeloma
2.	Amyloidosis
3.	Plasmacytoma
4.	Paraproteinemias (Monoclonal Gammopathy)
5.	Plasma Cell Leukemia

Experts

1.	Landgren, Ola: 16 articles (11/2022 - 05/2011)
2.	Rajkumar, S Vincent: 16 articles (10/2020 - 02/2002)
3.	Korde, Neha: 14 articles (11/2022 - 05/2011)
4.	Kyle, Robert A: 13 articles (01/2020 - 02/2002)
5.	Gertz, Morie A: 10 articles (01/2021 - 12/2002)
6.	Dispenzieri, Angela: 9 articles (01/2021 - 07/2004)
7.	Dispenzieri, A: 8 articles (01/2021 - 08/2001)
8.	Rajkumar, S V: 8 articles (01/2021 - 08/2001)
9.	Mailankody, Sham: 7 articles (11/2022 - 09/2014)
10.	Bladé, Joan: 7 articles (01/2022 - 09/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Smoldering Multiple Myeloma:

1.	Lenalidomide (CC 5013)FDA Link 10/01/2020 - "We conducted a randomized trial that assessed the efficacy of single-agent lenalidomide compared with observation in patients with intermediate- or high-risk smoldering multiple myeloma. " 10/01/2020 - "Randomized Trial of Lenalidomide Versus Observation in Smoldering Multiple Myeloma." 12/01/2016 - "First, treatment of smoldering multiple myeloma (SMM) remains investigational to date, although a randomized trial showed a survival gain in high-risk patients receiving lenalidomide. " 12/01/2021 - "The benefits of early intervention using lenalidomide for high-risk smoldering multiple myeloma: emerging data and its promising clinical impact." 04/01/2010 - "This review describes the mechanism of action of lenalidomide in myeloma which provides the basis for its clinical use in newly diagnosed, relapsed/refractory, and high-risk smoldering myeloma in combination with other agents. "
2.	Dexamethasone (Maxidex)FDA LinkGeneric 10/01/2022 - "Lenalidomide-dexamethasone versus observation in high-risk smoldering myeloma after 12 years of median follow-up time: A randomized, open-label study." 02/01/2015 - "Although the current standard of care is not to treat, a randomized trial in high-risk smoldering multiple myeloma patients comparing those allocated to receive early treatment with lenalidomide plus dexamethasone with those under observation reported a significant benefit with respect to time to progression and overall survival. " 10/01/2012 - "From the 32 smoldering myeloma patients, 18 were studied at baseline and 22 after nine cycles of lenalidomide/dexamethasone treatment following the QUIREDEX trial (including 8 from baseline). " 11/01/2022 - "Ixazomib and dexamethasone in high risk smoldering multiple myeloma: a clinical and correlative pilot study." 08/01/2013 - "Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma."
3.	Thalidomide (Thalomid)FDA Link 08/01/2001 - "Thalidomide for previously untreated indolent or smoldering multiple myeloma." 10/15/2008 - "Seven-year median time to progression with thalidomide for smoldering myeloma: partial response identifies subset requiring earlier salvage therapy for symptomatic disease." 12/01/2002 - "The optimum pretransplant induction regimen for multiple myeloma is described, and outcomes for early and delayed transplantation, one versus two transplants, the role of thalidomide in smoldering multiple myeloma, and the role of maintenance therapy are discussed. " 01/01/2013 - "A phase III randomized trial of thalidomide plus zoledronic acid versus zoledronic acid alone in patients with asymptomatic multiple myeloma." 01/01/2003 - "To evaluate the activity of thalidomide in patients with asymptomatic multiple myeloma and of thalidomide-dexamethasone in patients with previously untreated symptomatic myeloma. "
4.	carfilzomibIBA 10/10/2017 - "Early results of a prospective phase 2 clinical trial of carfilzomib, lenalidomide, and dexamethasone followed by lenalidomide maintenance in high-risk smoldering myeloma showed promising results that were previously published. " 09/01/2015 - "To assess the safety and efficacy of carfilzomib-lenalidomide-dexamethasone therapy in NDMM and high-risk smoldering multiple myeloma (SMM). " 11/01/2021 - "Carfilzomib, Lenalidomide, and Dexamethasone Followed by Lenalidomide Maintenance for Prevention of Symptomatic Multiple Myeloma in Patients With High-risk Smoldering Myeloma: A Phase 2 Nonrandomized Controlled Trial." 11/01/2021 - "To evaluate the use of carfilzomib, lenalidomide, and dexamethasone (KRd) with lenalidomide maintenance therapy as early intervention in high-risk smoldering myeloma and to determine the rates of minimal residual disease (MRD)-negative complete response (CR). "
5.	Bortezomib (Velcade)FDA Link 01/01/2014 - "Resolution of bilateral cystoid macular edema and subfoveal serous retinal detachments after treatment with bortezomib in a patient with "smoldering" multiple myeloma." 01/01/2020 - "The patient re-achieved molecular remission after resumption of imatinib, but his MGUS progressed to smoldering myeloma and he was eventually diagnosed with multiple myeloma (MM) and initiated on treatment for MM with thalidomide, bortezomib and dexamethasone. " 01/01/2020 - "The patient re-achieved molecular remission after resumption of imatinib, but his MGUS progressed to smoldering myeloma and he was eventually diagnosed with multiple myeloma (MM) and initiated on treatment for MM with thalidomide, bortezomib and dexamethasone. " 01/01/2016 - "Circulating vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and selectins were prospectively measured in 145 newly-diagnosed patients with symptomatic myeloma (NDMM), 61 patients with asymptomatic/smoldering myeloma (SMM), 47 with monoclonal gammopathy of undetermined significance (MGUS) and 87 multiple myeloma (MM) patients at first relapse who received lenalidomide- or bortezomib-based treatment (RD, n=47; or VD, n=40). "
6.	Imatinib Mesylate (Gleevec)FDA Link 05/01/2010 - "We describe a 72-year-old woman who was diagnosed with asymptomatic multiple myeloma (MM) while being treated for Philadelphia (Ph)-positive chronic myeloid leukemia (CML) with imatinib mesylate (400 mg/day). " 01/01/2020 - "The patient re-achieved molecular remission after resumption of imatinib, but his MGUS progressed to smoldering myeloma and he was eventually diagnosed with multiple myeloma (MM) and initiated on treatment for MM with thalidomide, bortezomib and dexamethasone. " 01/01/2020 - "The patient re-achieved molecular remission after resumption of imatinib, but his MGUS progressed to smoldering myeloma and he was eventually diagnosed with multiple myeloma (MM) and initiated on treatment for MM with thalidomide, bortezomib and dexamethasone. "
7.	daratumumabIBA 10/01/2021 - "Further investigations are underway to continue to expand the reach of daratumumab, including large phase III collaborative trials to assess the efficacy of daratumumab as part of post-transplant maintenance and its impact on smoldering myeloma. " 01/01/2021 - "Evaluation of Cardiac Repolarization in the Randomized Phase 2 Study of Intermediate- or High-Risk Smoldering Multiple Myeloma Patients Treated with Daratumumab Monotherapy." 01/01/2020 - "Daratumumab monotherapy for patients with intermediate-risk or high-risk smoldering multiple myeloma: a randomized, open-label, multicenter, phase 2 study (CENTAURUS)." 05/01/2020 - "We report a case in whom response of both the acquired von Willebrand syndrome and smoldering multiple myeloma persist 14 months after daratumumab treatment discontinuation." 01/01/2021 - "Here, we report the use of CD38 monoclonal antibody daratumumab (9-mo course) in a kidney allograft recipient diagnosed with smoldering myeloma and anti-HLA class II donor-specific antibody-positive chronic active AMR 13 years after transplantation. "
8.	Proteins (Proteins, Gene)FDA Link 01/01/2022 - "The M-protein turned from negative to positive during the course, and a bone marrow biopsy showed smoldering myeloma. " 01/01/2022 - "Smoldering multiple myeloma (SMM) is a heterogeneous group of asymptomatic plasma cell disorder characterized by the presence of monoclonal protein ≥ 30 g/L and/or 10-60% of bone marrow plasma cells and no evidence of SLiM-CRAB criteria according to the 2014 International Myeloma Working Group (IMWG) recommendations. " 01/01/2018 - "Response to 'Evolving M-protein pattern in patients with smoldering multiple myeloma: impact on early progression'." 01/01/2018 - "The pattern of the M-protein in smoldering myeloma over the time: an evolving risk factor." 01/01/2018 - "Evolving M-protein pattern in patients with smoldering multiple myeloma: impact on early progression."
9.	Immunoglobulin G (IgG)IBA 11/01/2022 - "The 53-year-old female was diagnosed with smoldering myeloma immunoglobulin G kappa and AL amyloidosis with deposits in fat and gastrointestinal tissue. " 11/01/2019 - "Herein, we describe a patient with immunoglobulin G (IgG)-lambda smoldering multiple myeloma with translocation t(4:14) who developed widespread ulcerative horny-like spicules, heralding rapid progression to overt myeloma requiring aggressive chemotherapy and autologous stem cell transplantation. " 01/01/2018 - "[Recurrent invasive pneumococcal disease in a patient with IgG-κ smoldering multiple myeloma]." 01/01/2018 - "A 68-year-old female with smoldering multiple myeloma (IgG-κ type) was admitted to the hospital owing to general fatigue, fever, and pain in the right leg. " 07/01/2013 - "This study aimed to evaluate the influence of a supervised training program on the changes in serum monoclonal protein level (i.e., IgG), percentage of bone marrow plasma cells (BMPCs), fitness performance, and cardiac autonomic control (i.e., HR variability [HRV] and HR complexity [HRC]) in a female diagnosed with smoldering multiple myeloma (SMM). "
10.	Immunoglobulin D (IgD)IBA 01/01/1988 - "The variant forms of multiple myeloma, including smoldering myeloma, plasma cell leukemia, nonsecretory myeloma, IgD myeloma, osteosclerotic myeloma, solitary plasmacytoma of bone, and extramedullary plasmacytoma, are briefly reviewed. " 08/01/1989 - "The author have discussed the following problems connected with the treatment of myeloma patients st 4 to 1988, including (1) ten-year survival in multiple myeloma; (2) complete remission in multiple myeloma; (3) complete remission in primary plasma cell leukemia; (4) systemic amyloidosis in multiple myeloma as the presenting symptom; (5) treatments for patients resistant to standard therapies; (6) treatments and courses of patients with IgD myeloma; (7) multiple myeloma in the aged; (8) treatments for patients with primary extramedullary plasmacytoma; (9) long-term observation of a patient with smoldering multiple myeloma; (10) the outcome of idiopathic Bence Jones proteinuria and (11) supportive therapies for multiple myeloma. "

Therapies and Procedures

1.	Therapeutics 09/01/2008 - "Smoldering myeloma in HIV patient: a complete remission after antiretroviral therapy." 01/01/2015 - "Novel therapies hold promise for high-risk smoldering multiple myeloma (SMM). " 01/01/2019 - "In summary, our results suggest that smoldering myeloma may be immunogenic in a subset of patients, and therapies that enhance antitumor T-cell responses may be effective in preventing its progression. " 01/01/2020 - "We do not recommend therapy for smoldering myeloma patients (standard or high risk). " 01/01/2019 - "In patients with smoldering multiple myeloma, the presence of at least one hyper-metabolic lytic lesions on FDG-PET may be considered as a criterion for initiating therapy. "
2.	Drug Therapy (Chemotherapy) 01/01/1993 - "We followed 95 patients with asymptomatic multiple myeloma without chemotherapy between 1974 and 1991. " 07/01/2016 - "Solitary Extramedullary Plasmacytoma of the Maxillary Sinus, Progressing to Smoldering Multiple Myeloma with Multifocal Skeletal Involvement, which Resolved Completely Following Chemotherapy Alone." 01/01/2019 - "Currently the standard of care for smoldering multiple myeloma (SMM) is "watch and wait." However, in recent years the treatment for multiple myeloma (MM) has shifted from cytotoxic chemotherapy with poor efficacy to less toxic, more effective treatments. " 11/01/2019 - "Herein, we describe a patient with immunoglobulin G (IgG)-lambda smoldering multiple myeloma with translocation t(4:14) who developed widespread ulcerative horny-like spicules, heralding rapid progression to overt myeloma requiring aggressive chemotherapy and autologous stem cell transplantation. " 01/01/1996 - "MM must be differentiated from smoldering multiple myeloma (SMM), which has an M-protein value of more than 30 g/l and more than 10% plasma cells in the bone marrow, but no other features of MM. The plasma cell labeling index (PCLI) and the presence of circulating plasma cells in the peripheral blood help to differentiate monoclonal gammopathy of undetermined significance and SMM from MM. The current median duration of survival with chemotherapy is about three years. "
3.	Stem Cell Transplantation 01/01/2018 - "These strategies are currently being examined in various stages of myeloma such as during consolidation post autologous stem cell transplantation, targeting minimal residual disease or even in high risk smoldering myeloma." 01/01/2021 - "This follow-up study a) established a highly sensitive single-tube 10-color MFC panel for MRD detection in myeloma samples carrying different disease burden (monoclonal gammopathy of unknown significance (MGUS), smoldering multiple myeloma (SMM), MM), b) evaluated additional, rarely used markers included in this panel, and c) assessed MRD levels and the predictive value in apheresis vs. BM samples of MM patients undergoing autologous stem cell transplantation (ASCT). " 11/01/2019 - "Herein, we describe a patient with immunoglobulin G (IgG)-lambda smoldering multiple myeloma with translocation t(4:14) who developed widespread ulcerative horny-like spicules, heralding rapid progression to overt myeloma requiring aggressive chemotherapy and autologous stem cell transplantation. "
4.	Immunotherapy 03/03/2016 - "There is significant interest in immunotherapy for the treatment of high-risk smoldering multiple myeloma (SMM), but no available data on the immune status of this particular disease stage. " 09/01/2023 - "A first case report of using chimeric antigen receptor T-cell immunotherapy to treat high-risk smoldering multiple myeloma." 11/14/2022 - "Immune biomarkers of response to immunotherapy in patients with high-risk smoldering myeloma."
5.	Transplantation 12/01/2002 - "The optimum pretransplant induction regimen for multiple myeloma is described, and outcomes for early and delayed transplantation, one versus two transplants, the role of thalidomide in smoldering multiple myeloma, and the role of maintenance therapy are discussed. " 01/01/2021 - "Here, we report the use of CD38 monoclonal antibody daratumumab (9-mo course) in a kidney allograft recipient diagnosed with smoldering myeloma and anti-HLA class II donor-specific antibody-positive chronic active AMR 13 years after transplantation. "