Clinical Course and Prognosis of Smoldering (Asymptomatic) Multiple Myeloma
- Study type
- Observational study
- Design
- Single-centre retrospective cohort study (review of the medical records of Mayo Clinic patients)
- Sample size
- 276 patients
- Source
- N Engl J Med · 2007
In plain words
Smouldering multiple myeloma is a condition in which the plasma cells in the bone marrow are abnormal, but the person does not yet have any symptoms. In this study, about 6 out of every 10 patients developed myeloma with symptoms or amyloidosis during follow-up, and the risk was highest in the first 5 years after diagnosis. The proportion of plasma cells in the bone marrow and the amount of monoclonal protein in the blood help predict the chance that the disease will progress.
Key results
Treatment arms and regimens
This is an observational study and no specific treatment intervention was evaluated. Patients were followed over the course of the disease. Dose details in the full text of the paper.
Source of the regimen details: Abstract of the paper
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Study population
All patients seen at Mayo Clinic between 1970 and 1995 who met the International Myeloma Working Group criteria for smouldering (asymptomatic) multiple myeloma.
Endpoints
Progression to symptomatic multiple myeloma or amyloidosis, and identification of risk factors associated with progression and outcome; factors examined included the size and type of the serum monoclonal protein, the presence of urinary light chains, the extent and pattern of bone marrow involvement and reduction of uninvolved immunoglobulins.
Safety and side effects
This was an observational study, and no safety data or adverse effects of a treatment intervention are reported in the abstract.
Clinical significance and place in guidelines
This study gives a clear picture of the natural history and time pattern of progression risk in smouldering myeloma and shows that the proportion of bone marrow plasma cells and the size of the serum monoclonal protein can be used for risk stratification. How these findings are applied in current clinical guidelines (including decisions on surveillance or treatment) should be checked in up-to-date guidelines; the abstract does not comment on this.
Limitations
Based on the abstract: the study was a retrospective review of records from a single centre (Mayo Clinic) and no treatment intervention was compared. Other limitations should be checked in the full text of the paper.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.