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Download COMy 2016 Treatment For Smoldering Myeloma: Mateos


Title: COMy 2016 Treatment For Smoldering Myeloma: Mateos
Uploaded on: 11 Jun 2016
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COMy - The 2nd World Congress on Controversies in Multiple Myeloma, April 28-30, 2016 Paris, France. "Treatment for Smoldering Myeloma" by Dr. María-Victoria Mateos (MD) University Hospital of Salamanca - IBSAL, Salamanca, Spain.
Smoldering Multiple Myeloma (SMM) is an asymptomatic disorder characterized by the presence of = or more than 3 g/dL serum M-protein and/or 10-60% bone marrow plasma cell infiltration with no myeloma-defining event. Kristinsson et al., through the Swedish Myeloma Registry, recently reported that 14% of patients
diagnosed with myeloma had SMM and, taking the world population as a reference, that the age-standardized incidence of SMM was 0.44 cases per 100,000 people. The risk of progression to active MM is not uniform, and several markers are useful for identifying patients at high risk of progression, approximately 50% at 2 years. The definition of the disease has recently been
revisited and asymptomatic MMs at 80-90% of progression risk at 2 years are now considered to be MMs. The biomarkers for the identification of this subgroup of patients are: 1) the presence of more than one focal lesions in magnetic resonance imaging, 2) more than 60% of plasma cells within the bone marrow or 3) a ratio of involved versus uninvolved serum free light ratio equal
to or higher than 100. For the rest of patients, the standard of care is observation, although a randomized trial in high-risk SMM patients comparing early treatment versus observation has shown early intervention to provide a significant benefit in terms of time to progression and overall survival. These findings highlight the need to follow a correct diagnosis by accurate risk stratification in order to plan an optimized follow-up according to the risk of
progression: if ultra high-risk of progression, patients should be called myeloma and treated; if low or intermediate risk of progression, it would be necessary to do follow-up every year or every two years; and if high-risk of progression to myeloma is present, the best option is the patients to be referred to a center
specialized in myeloma and include them in a clinical trial if available.

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