The risk of progression of smoldering multiple myeloma (SMM) to active multiple myeloma is not uniform, and several markers may contribute to identify patients at high risk of progression (less than 50 percent progressions within two years). The definition of multiple myeloma has recently been revisited, and a subgroup of high-risk patients at 70 to 80 percent risk of progression at two years are now considered to be active multiple myeloma candidates for treatment. Although the current standard of care for SMM is not to treat, a randomized trial in high-risk SMM patients comparing early treatment versus observation has shown a significant benefit in terms of time to progression and overall survival for early intervention. Dr. San Miguel will review the most valuable biomarkers for accurate risk stratification in order to plan an optimized follow-up according to the risk of progression, as well as clinical trials investigating early treatment in high-risk SMM.
Jesús San Miguel
Active, International, Emeritus, and Honorary Members
Associate, International Associate, Student, and Resident Members