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Review
. 2020 Mar;33(1):101152.
doi: 10.1016/j.beha.2020.101152. Epub 2020 Jan 25.

High-risk smoldering myeloma versus early detection of multiple myeloma: Current models, goals of therapy, and clinical implications

Chutima Kunacheewa  1 , Elisabet E Manasanch  2
Affiliations
Review

High-risk smoldering myeloma versus early detection of multiple myeloma: Current models, goals of therapy, and clinical implications

Chutima Kunacheewa et al. Best Pract Res Clin Haematol. 2020 Mar.

Abstract

Multiple myeloma, a bone marrow cancer, is preceded by precursor stages called monoclonal gammopathy of unknown significance and smoldering multiple myeloma. Over the past few years, highly effective and safe therapies have been made available to treat multiple myeloma. This represents a major breakthrough and has major therapeutic implications. Treatment for multiple myeloma has evolved to include treatment of precursor stages (early treatment) as these therapies are shown to be safe and effective also in smoldering myeloma. Randomized studies have shown that early treatment can delay the onset of multiple myeloma and even improve overall survival compared to observation in smoldering myeloma. The best therapeutic course and selection of patients with smoldering myeloma to treat is still a matter of debate. In this manuscript, we review the definition, management, clinical implications of smoldering myeloma and early detection of myeloma in the current context and with up-to-date data.

Keywords: Classification; Early myeloma; Smoldering myeloma; Treatment.

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Conflict of interest statement

Declaration of competing interest C. Kunacheewa reports no conflicts of interest. E. Manasanch has received research support from Sanofi, Quest Diagnostics, Novartis, JW. Pharma, Merck; consultant fees from Celgene, Janssen, Sanofi and Adaptive Biotechnologies.

Figures

Figure 1:
Figure 1:
Smoldering multiple myeloma heterogeneity and risk group categories
See this image and copyright information in PMC

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