title: Future Directions in the Evaluation and Treatment of Precursor Plasma Cell Disorders.
abstract: Multiple myeloma (MM) is an incurable disease that progresses from a premalignant stage termed monoclonal gammopathy of undetermined significance (MGUS) and an intermediate stage of smoldering multiple myeloma (SMM). Recent major advances in therapy with more effective and less toxic treatments have brought reconsideration of early therapeutic intervention in management of SMM, with the goal of reducing progression of the disease before the occurrence of end-organ damage to MM and improving survival. Key to this effort is accurate identification of patients at high risk of progression who would truly benefit from early intervention. In this review, we discuss the current definitions, risk factors, risk stratification, prognosis, and management of MGUS and SMM, as well as new emerging therapeutic options under active investigation.
authors.affiliation: From the Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
authors.forename: Salomon
authors.initials: S
authors.lastname: Manier
authors.affiliation: From the Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
authors.forename: Karma Z
authors.initials: KZ
authors.lastname: Salem
authors.affiliation: From the Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
authors.forename: David
authors.initials: D
authors.lastname: Liu
authors.affiliation: From the Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
authors.forename: Irene M
authors.initials: IM
authors.lastname: Ghobrial
mesh_terms: D019468:Disease Management; D018450:Disease Progression; D006801:Humans; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D010265:Paraproteinemias / Q000188:drug therapy* / Q000473:pathology; D010950:Plasma Cells / Q000187:drug effects / Q000473:pathology*; D011379:Prognosis; D012307:Risk Factors