Smoldering multiple myeloma

Last revised by Daniel J Bell on 21 Jan 2020

Citation, DOI, disclosures and article data

Citation:

Smith H, Bell D, Knipe H, et al. Smoldering multiple myeloma. Reference article, Radiopaedia.org (Accessed on 24 Apr 2024) https://doi.org/10.53347/rID-60252

DOI:

https://doi.org/10.53347/rID-60252

Permalink:

https://radiopaedia.org/articles/60252

rID:

60252

Article created:

14 May 2018, Hamish Smith

Disclosures:

At the time the article was created Hamish Smith had no recorded disclosures.

View Hamish Smith's current disclosures

Last revised:

21 Jan 2020, Daniel J Bell ◉

Disclosures:

At the time the article was last revised Daniel J Bell had no recorded disclosures.

View Daniel J Bell's current disclosures

Revisions:

7 times, by 5 contributors - see full revision history and disclosures

Systems:

Haematology

Tags:

cases, rg_39_4_edit

Synonyms:

Smouldering multiple myeloma (SMM)
Smouldering myeloma

Smoldering multiple myeloma is a premalignant stage between monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma.

serum M-protein ≥3 g/dL or urinary monoclonal protein ≥500 mg per 24 hours and/or clonal plasma cell population present in the bone marrow (10-60% cellularity)
as well as the absence of a 'myeloma-defining event' (e.g. hypercalcemia, renal insufficiency, lytic bone lesions, anemia) or amyloidosis

Radiographic features

MRI

MRI is of prognostic importance in smoldering multiple myeloma ². 50% of patients with smoldering multiple myeloma have abnormal bone marrow on MRI ranging from focal to diffuse changes ². Patients with marrow changes on MRI have a much shorter time to progression than those without ².

Treatment and prognosis

On average 10% of smoldering multiple myeloma patients per year will develop active multiple myeloma ^3,5.

References

1. Kyle RA, Durie BG, Rajkumar SV, Landgren O, Blade J, Merlini G, Kröger N, Einsele H, Vesole DH, Dimopoulos M, San Miguel J, Avet-Loiseau H, Hajek R, Chen WM, Anderson KC, Ludwig H, Sonneveld P, Pavlovsky S, Palumbo A, Richardson PG, Barlogie B, Greipp P, Vescio R, Turesson I, Westin J, Boccadoro M. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management. (2010) Leukemia. 24 (6): 1121-7. doi:10.1038/leu.2010.60 - Pubmed
2. Mariette X, Zagdanski AM, Guermazi A, Bergot C, Arnould A, Frija J, Brouet JC, Fermand JP. Prognostic value of vertebral lesions detected by magnetic resonance imaging in patients with stage I multiple myeloma. (1999) British journal of haematology. 104 (4): 723-9. Pubmed
3. S. Vincent Rajkumar, Ola Landgren, María-Victoria Mateos. Smoldering multiple myeloma. (2015) Blood. 125 (20): 3069. doi:10.1182/blood-2014-09-568899 - Pubmed
4. Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos MV, Kumar S, Hillengass J, Kastritis E, Richardson P, Landgren O, Paiva B, Dispenzieri A, Weiss B, LeLeu X, Zweegman S, Lonial S, Rosinol L, Zamagni E, Jagannath S, Sezer O, Kristinsson SY, Caers J, Usmani SZ, Lahuerta JJ, Johnsen HE, Beksac M, Cavo M, Goldschmidt H, Terpos E, Kyle RA, Anderson KC, Durie BG, Miguel JF. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. (2014) The Lancet. Oncology. 15 (12): e538-48. doi:10.1016/S1470-2045(14)70442-5 - Pubmed
5. 12. Alípio G. Ormond Filho, Bruno C. Carneiro, Daniel Pastore, Igor P. Silva, Sâmia R. Yamashita, Flávio D. Consolo, Vânia T. M. Hungria, Alex F. Sandes, Edgar G. Rizzatti, Marcelo A. C. Nico. Whole-Body Imaging of Multiple Myeloma: Diagnostic Criteria. (2019) RadioGraphics. 39 (4): 1077-1097. doi:10.1148/rg.2019180096 - Pubmed