Smouldering myeloma
Smouldering myeloma, also known as smoldering myeloma, indolent myeloma or asymptomatic myeloma, is a very slow-growing type of myeloma which is characterised by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein (M protein). Smouldering myeloma is a very early phase of myeloma and is devoid of symptoms but a bone marrow biopsy shows definite evidence of myeloma.
Diagnosis
Smouldering myeloma is characterised by:
- Serum paraprotein >30 g/L AND/OR
- Clonal plasma cells >10% on bone marrow biopsy AND
- No myeloma-related organ or tissue impairment
Prognosis
Smouldering myeloma with an increasingly abnormal serum free light chain (FLC) ratio is associated with a higher risk for progression to active multiple myeloma.[1]
Treatment
Treatment for multiple myeloma is focused on therapies that decrease the clonal plasma cell population and consequently decrease the signs and symptoms of disease. If the disease is completely asymptomatic (i.e. there is a paraprotein and an abnormal bone marrow population but no end-organ damage), as in smoldering myeloma, treatment is typically deferred, or restricted to clinical trials.[2]
They are generally responsive to IL-1β neutralisation.[3]
References
Further reading
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External links
- Smouldering myeloma Infosheet
- Smoldering Myeloma on International Myeloma Foundation.
