title: High-risk smoldering myeloma: Perspective on watchful monitoring.
abstract: In a 2008 paper, Dispenzieri and colleagues at the Mayo Clinic proposed a risk stratification system for patients with smoldering multiple myeloma (SMM) based on the presence of three risk factors: serum M-protein ≥3 g/dL, bone marrow plasma cell percentage ≥10%, and a free light chain (FLC) ratio (κ to λ) of either ≤0.125 or ≥8. The patient in this vignette has all three risk factors, classifying him as high-risk, with an associated median time to progression (TTP) of 1.9 years. This is significantly worse than a patient with intermediate-risk (median TTP 5.1 years) or low-risk (10 years) disease.
authors.affiliation: Division of Hematology/Oncology, Columbia University Medical Center, New York, NY. Electronic address: SL4076@columbia.edu.
authors.forename: Siyang
authors.initials: S
authors.lastname: Leng
authors.affiliation: Multiple Myeloma and Amyloidosis Service, Columbia University Medical Center, New York, NY.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lentzsch
mesh_terms: D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000209:etiology / Q000628:therapy*; D012307:Risk Factors
keywords: Risk stratification; Smoldering multiple myeloma; Treatment