{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:15:16Z","timestamp":1790388916730,"version":"4.1.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000054","name":"U.S. Department of Health & Human Services | NIH | National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Leukemia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Smoldering multiple myeloma (SMM) has long been viewed as an intermediate precursor state, monitored until symptoms or organ dysfunction signaled the transition to active multiple myeloma (MM). Over the past decade, however, major advances in molecular biology, modern imaging, and immunotherapy have reshaped our understanding of early plasma cell disorders. The recent FDA approval of daratumumab for high-risk SMM marks a historic turning point. For the first time, early intervention is not only feasible but clinically validated. This evolving framework challenges long-standing assumptions regarding diagnostic boundaries, risk stratification, and the traditional \u201cwatch-and-wait\u201d paradigm. It is logical to conjecture that emerging and future technologies will redefine portions of today\u2019s SMM population as early myeloma, while others may ultimately be reclassified as benign monoclonal gammopathies. An interesting question is whether there will be any SMM patients left? This article reviews how the field has arrived at this new therapeutic era, outlines its limitations, and highlights key scientific and clinical questions that will shape the next generation of SMM research and care.<\/jats:p>","DOI":"10.1038\/s41375-026-02979-2","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:46:02Z","timestamp":1777963562000},"page":"1137-1141","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Smoldering multiple myeloma in transition: redefining early myeloma in the modern era"],"prefix":"10.1038","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6485-4839","authenticated-orcid":false,"given":"Ola","family":"Landgren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"2979_CR1","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1182\/hematology.2021000303","volume":"2021","author":"O Landgren","year":"2021","unstructured":"Landgren O. Advances in MGUS diagnosis, risk stratification, and management: introducing myeloma-defining genomic events. Hematology Am Soc Hematol Educ Program. 2021;2021:662\u201372.","journal-title":"Hematology Am Soc Hematol Educ Program"},{"key":"2979_CR2","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1111\/j.1600-0609.1993.tb00148.x","volume":"50","author":"M Hjorth","year":"1993","unstructured":"Hjorth M, Hellquist L, Holmberg E, Magnusson B, Rodjer S, Westin JMyeloma Group of Western Sweden Initial versus deferred melphalan-prednisone therapy for asymptomatic multiple myeloma stage I-a randomized study. Eur J Haematol. 1993;50:95\u2013102.","journal-title":"Eur J Haematol"},{"key":"2979_CR3","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1056\/NEJMc2507995","volume":"393","author":"MA Dimopoulos","year":"2025","unstructured":"Dimopoulos MA, Voorhees PM, Rajkumar SV. Daratumumab for high-risk smoldering multiple myeloma. Reply. N Engl J Med. 2025;393:617.","journal-title":"N Engl J Med"},{"key":"2979_CR4","doi-asserted-by":"publisher","first-page":"1678","DOI":"10.1001\/jamaoncol.2021.3971","volume":"7","author":"D Kazandjian","year":"2021","unstructured":"Kazandjian D, Hill E, Dew A, Morrison C, Roswarski J, Korde N, et al. Carfilzomib, lenalidomide, and dexamethasone followed by lenalidomide maintenance for prevention of symptomatic multiple myeloma in patients with high-risk smoldering myeloma: a phase 2 nonrandomized controlled trial. JAMA Oncol. 2021;7:1678\u201385.","journal-title":"JAMA Oncol"},{"key":"2979_CR5","doi-asserted-by":"publisher","first-page":"1840","DOI":"10.1038\/s41375-020-0718-z","volume":"34","author":"CO Landgren","year":"2020","unstructured":"Landgren CO, Chari A, Cohen YC, Spencer A, Voorhees P, Estell JA, et al. Daratumumab monotherapy for patients with intermediate-risk or high-risk smoldering multiple myeloma: a randomized, open-label, multicenter, phase 2 study (CENTAURUS). 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