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The purpose of this study was to investigate to which extent the development of end\u2010organ damage at progression to MM was reduced under the updated guidelines. In this prospective observational cohort study (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> Identifier: NCT01374412), between 2014 and 2020, 96 SMM patients prospectively underwent whole\u2010body magnetic resonance imaging (wb\u2010MRI) and serological follow\u2010up at baseline and every 6\u2009months thereafter. A total of 22 patients progressed into MM during follow\u2010up, of which seven (32%) showed SLiM\u2010criteria only but no end\u2010organ damage. Four (57%) of the seven patients who progressed by SLiM\u2010criteria only progressed with &gt;1 focal lesion (FL) or a growing FL, and three (43%) due to serum free light\u2010chain\u2010ratio \u2265100. Fifteen (68%) out of 22 patients who progressed still suffered from end\u2010organ damage at progression. The updated disease definition reduced the proportion of SMM patients suffering from end\u2010organ damage at progression to MM by one third. wb\u2010MRI is an important tool for detection of SMM patients who progress to MM without end\u2010organ damage.<\/jats:p>","DOI":"10.1111\/bjh.18232","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T11:54:22Z","timestamp":1653393262000},"page":"65-75","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Whole\u2010body magnetic resonance imaging plus serological follow\u2010up for early identification of progression in smouldering myeloma patients to prevent development of end\u2010organ damage"],"prefix":"10.1111","volume":"199","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8092-8380","authenticated-orcid":false,"given":"Markus","family":"Wennmann","sequence":"first","affiliation":[{"name":"Division of Radiology German Cancer Research 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