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Smoldering multiple myeloma requiring treatment: time for a new definition?
| Content Provider | Scilit |
|---|---|
| Author | Dispenzieri, Angela Stewart, A. Keith Chanan-Khan, Asher Rajkumar, S. Vincent Kyle, Robert A. Fonseca, Rafael Kapoor, Prashant Bergsagel, P. Leif McCurdy, Arleigh Gertz, Morie A. Lacy, Martha Q. Lust, John A. Russell, Stephen J. Zeldenrust, Steven R. Reeder, Craig Roy, Vivek Buadi, Francis Dingli, David Hayman, Suzanne R. Leung, Nelson Lin, Y. Mikhael, Joseph Kumar, Shaji K. |
| Copyright Year | 2013 |
| Description | Smoldering multiple myeloma (SMM) bridges the gap between monoclonal gammopathy of undetermined significance (a mostly premalignant disorder) and active multiple myeloma (MM). Until recently, no interventional study in patients with SMM showed improved overall survival (OS) with therapy as compared with observation. A report from the PETHEMA-GEM (Programa Español de Tratamientos en Hematologica) group described both fewer myeloma-related events and better OS among patients with high-risk SMM who were treated with lenalidomide and dexamethasone. This unique study prompted us to review current knowledge about SMM and address the following questions: (1) Are there patients currently defined as SMM who should be treated routinely? (2) Should the definitions of SMM and MM be reconsidered? (3) Has the time come when not treating is more dangerous than treating? (4) Could unintended medical harm result from overzealous intervention? Our conclusion is that those patients with the highest-risk SMM (extreme bone marrow plasmacytosis, extremely abnormal serum immunoglobulin free light chain ratio, and multiple bone lesions detected only by modern imaging) should be reclassified as active MM so that they can receive MM-appropriate therapy and the paradigm of careful observation for patients with SMM can be preserved. |
| Related Links | http://www.bloodjournal.org/content/bloodjournal/122/26/4172.full.pdf |
| Ending Page | 4181 |
| Page Count | 10 |
| Starting Page | 4172 |
| DOI | 10.1182/blood-2013-08-520890 |
| Journal | Blood |
| Issue Number | 26 |
| Volume Number | 122 |
| Language | English |
| Publisher | American Society of Hematology |
| Publisher Date | 2013-12-19 |
| Access Restriction | Open |
| Subject Keyword | Hematology Bone Marrow Dexamethasone Smoldering Multiple Myeloma Immunoglobulin Smm Who Journal: Blood (Vol- 2017, Issue- 26) |
| Content Type | Text |
| Resource Type | Article |
