title: Is it time for preemptive drug treatment of asymptomatic (smoldering) multiple myeloma?
abstract: Asymptomatic (smoldering) multiple myeloma is a heterogeneous plasma cell proliferative disorder with a variable rate of progression to active multiple myeloma or related disorders. Hypercalcemia, renal insufficiency, anemia, bone lesions or recurrent bacterial infections characterize active multiple myeloma. Some patients with asymptomatic myeloma develop active disease rapidly, and others can stay asymptomatic for many years. Those who are likely to progress within the first 2 years of diagnosis have been categorized as having high-risk disease. The availability of novel agents in the treatment of active multiple myeloma and our better understanding of the heterogeneity of asymptomatic multiple myeloma have spurred interest in the early treatment of these patients. We have reviewed the current proposed definitions of high-risk asymptomatic multiple myeloma, the concerns about future therapy in view of the transient nature, remissions and toxicities of the therapies, and the eventual relapses that characterize this incurable disease.
authors.affiliation: Hematology and Oncology, Beaumont Health System , Royal Oak, MI , USA.
authors.forename: Adewale
authors.initials: A
authors.lastname: Fawole
authors.forename: Rafat
authors.initials: R
authors.lastname: Abonour
authors.forename: Michael
authors.initials: M
authors.lastname: Stender
authors.forename: Seerin
authors.initials: S
authors.lastname: Shatavi
authors.forename: Susanna
authors.initials: S
authors.lastname: Gaikazian
authors.forename: Joseph
authors.initials: J
authors.lastname: Anderson
authors.forename: Ishmael
authors.initials: I
authors.lastname: Jaiyesimi
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D058070:Asymptomatic Diseases / Q000628:therapy*; D002986:Clinical Trials as Topic; D060965:Clonal Evolution; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D006801:Humans; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: Myeloma; chemotherapeutic approaches; cytogenetics