{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T08:39:35Z","timestamp":1771403975460,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Introduction: Smoldering multiple myeloma (SMM) is a precursor condition to active multiple myeloma (MM). While surveillance is standard, data on its effectiveness in preventing irreversible complications is limited. Methods: We conducted a two-center matched retrospective cohort study comparing 57 patients who progressed from SMM (pSMM) with 57 de novo MM (dnMM) patients, matched by age and diagnosis year. Primary endpoints were end-organ damage and progression-free survival (PFS). Results: Median surveillance prior to progression in pSMM was 40 months. At active MM diagnosis, irreversible renal\/bone complications were observed in 44% of pSMM patients compared with 72% of dnMM (p = 0.002). dnMM patients presented more frequently with hypercalcemia (12.3% vs. 1.8%, p = 0.03), lytic lesions (67% vs. 45%, p = 0.02), pathological fractures (31% vs. 10%, p = 0.008), and detrimental bone disease (58% vs. 25%, p &lt; 0.001). ISS and R-ISS stages were higher in dnMM, while treatment patterns were similar. At 3 years, PFS was significantly higher in pSMM (59% vs. 30%, p = 0.01), as was overall survival (OS; 92% vs. 76%, p = 0.01). Clinical surveillance was associated with reduced disease burden, fewer irreversible complications, and improved PFS and OS compared with dnMM. Conclusion: These findings support surveillance effectiveness and highlight the need to optimize follow-up strategies.<\/jats:p>","DOI":"10.3390\/cancers18040658","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T07:50:30Z","timestamp":1771401030000},"page":"658","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surveillance of Smoldering Myeloma Patients Who Progress to Active Disease Is Associated with Favorable Outcomes"],"prefix":"10.3390","volume":"18","author":[{"given":"Gil","family":"Fridberg","sequence":"first","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inbar","family":"Cohen","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Hematology Institute, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva 6356710, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0239-9265","authenticated-orcid":false,"given":"Renana","family":"Robinson","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Hematology Institute, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva 6356710, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iuliana","family":"Vaxman","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Hematology Institute, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva 6356710, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3741-689X","authenticated-orcid":false,"given":"Tamir","family":"Shragai","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svetlana","family":"Trestman","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2589-8473","authenticated-orcid":false,"given":"Tomer","family":"Ziv-Baran","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natan","family":"Melamed","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9973-639X","authenticated-orcid":false,"given":"Pia","family":"Raanani","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Hematology Institute, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva 6356710, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irit","family":"Avivi","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9061-7287","authenticated-orcid":false,"given":"Yael C.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","article-title":"International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma","volume":"15","author":"Rajkumar","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1046\/j.1365-2141.2003.04654.x","article-title":"Smoldering multiple myeloma: Natural history 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