{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T22:05:58Z","timestamp":1774389958123,"version":"3.50.1"},"reference-count":50,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2010,2,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> To provide an overview on smoldering (asymptomatic) multiple myeloma (SMM) including current diagnostic criteria, predictors of progression, pattern of progression, and outcome. <\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p> A comprehensive review of the literature on risk factors for progression, treatment attempts to delay progression and outcome in patients with SMM. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> The risk factors for progression of SMM include: plasma cell mass including M-protein size and percentage of bone marrow clonal plasma cells (BMPC), abnormal free light chain ratio, proportion of phenotypically abnormal BMPC, immunoparesis, evolution pattern (evolving v nonevolving), and pattern of magnetic resonance imaging abnormalities. Most patients with SMM progress with anemia and\/or skeletal involvement. Immediate therapy with cytotoxic agents, such as melphalan\/prednisone has not resulted in improved outcome. Patients should not be treated until progressive disease with end-organ damage occurs. Increasing anemia is the most reliable indicator of progression. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> These recently recognized predictors of outcome may be helpful for better disease monitoring and for investigation of new treatment approaches. Thus, recommendations for follow-up every to 3 to 6 months depending on the risk of progression are suggested, and clinical trials with new noncytotoxic biologically derived agents to delay progression, particularly in high-risk patients, are ongoing. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2009.22.2257","type":"journal-article","created":{"date-parts":[[2009,12,22]],"date-time":"2009-12-22T02:42:51Z","timestamp":1261449771000},"page":"690-697","source":"Crossref","is-referenced-by-count":94,"title":["Smoldering (Asymptomatic) Multiple Myeloma: Current Diagnostic Criteria, New Predictors of Outcome, and Follow-Up Recommendations"],"prefix":"10.1200","volume":"28","author":[{"given":"Joan","family":"Blad\u00e9","sequence":"first","affiliation":[{"name":"From the Hematology Department, Institute of Hematology and Oncology, Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer, Hospital Cl\u00ednic, University of Barcelona, Barcelona, Spain; Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece; and the Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meletios","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"From the Hematology Department, Institute of Hematology and Oncology, Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer, Hospital Cl\u00ednic, University of Barcelona, Barcelona, Spain; Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece; and the Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Rosi\u00f1ol","sequence":"additional","affiliation":[{"name":"From the Hematology Department, Institute of Hematology and Oncology, Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer, Hospital Cl\u00ednic, University of Barcelona, Barcelona, Spain; Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece; and the Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. 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