International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM)

Smoldering multiple myeloma (SMM) is an asymptomatic precursor state of multiple myeloma (MM). The International Myeloma Working Group (IMWG) has developed a risk stratification model for SMM based on three independent factors: serum M-protein >2 g/dL, involved to uninvolved free light-chain ratio >20, and marrow plasma cell infiltration >20%. These factors allow for categorization of patients into low, intermediate, and high-risk groups, with further stratification possible through the inclusion of cytogenetic abnormalities.​ The risk stratification model has the potential to identify high-risk SMM patients for clinical research and routine practice. ​ Early treatment in SMM may reduce the risk of progression to MM. ​Revised criteria for the definition of SMM and MM help identify a subset of SMM patients with a high risk of progression. This study provides valuable insights into the risk factors and progression of SMM, as well as the potential for individualized risk assessment. ​

Important points:

1. Smoldering multiple myeloma (SMM) is an asymptomatic precursor state of multiple myeloma (MM). ​
2. The International Myeloma Working Group (IMWG) has developed a risk stratification model for SMM. ​
3. The risk stratification model is based on three independent factors: serum M-protein >2 g/dL, involved to uninvolved free light-chain ratio >20, and marrow plasma cell infiltration >20%. ​
4. Patients can be categorized into low, intermediate, and high-risk groups using these factors. ​
5. Cytogenetic abnormalities can be included for further stratification. ​
6. The risk stratification model can help identify high-risk SMM patients for clinical research and routine practice. ​
7. Early treatment in SMM may reduce the risk of progression to MM. ​
8. Revised criteria for the definition of SMM and MM aid in identifying SMM patients at high risk of progression. ​
9. The study provides insights into the risk factors and progression of SMM and highlights the potential for individualized risk assessment. ​

Authors:

María-Victoria Mateos, Shaji Kumar, Meletios A. Dimopoulos, Verónica González-Calle1, Efstathios Kastritis, Roman Hajek, Carlos Fernández De Larrea, Gareth J. Morgan, Giampaolo Merlini, Hartmut Goldschmidt, Catarina Geraldes, Alessandro Gozzetti, Charalampia Kyriakou, Laurent Garderet, Markus Hansson, Elena Zamagni, Dorotea Fantl, Xavier Leleu, Byung-Su Kim, Graça Esteves, Heinz Ludwig, Saad Usmani, Chang-Ki Min, Ming Qi, Jon Ukropec, Brendan M. Weiss, S. Vincent Rajkumar, Brian G. M. Durie and Jesús San-Miguel

Citation:

Mateos, MV., Kumar, S., Dimopoulos, M.A. et al. International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM). Blood Cancer J. 10, 102 (2020). https://doi.org/10.1038/s41408-020-00366-3