Smoldering (Asymptomatic) Multiple Myeloma: Revisiting the Clinical Dilemma and Looking Into the Future

摘要: Recent studies show that multiple myeloma (MM) is consistently preceded by an asymptomatic precursor state. Smoldering MM (SMM) a defined M-protein concentration ≥ 3 g/dL and/or 10% bone marrow plasma cells, in the absence of end-organ damage. Compared with individuals diagnosed monoclonal gammopathy undetermined significance (MGUS), patients SMM have much higher annual risk developing MM. However, based on clinical observations, natural history varies greatly, from stable MGUS-like disease to highly progressive disease. Using conventional markers, can be stratified into groups. Importantly, because considerable molecular heterogeneity, we currently lack reliable markers predict prognosis for individual patients. Furthermore, until recently, potent drugs reasonable toxicity profiles not been available development early treatment strategies. Consequently, current guidelines emphasize application close monitoring followed when patient develops symptomatic This review focuses novel biomarkers, profiles, and microenvironmental interactions interest myelomagenesis. We also discuss how integration biologic could facilitate strategies high-risk future.