Does anyone have good, scientific articles on smoldering multiple myeloma? I was dx'd 4.5 yrs ago w/ it. My labs are fine as are the 2 sets of skeletal series I've had in that time.
Specifically what i'd like to know is does all smoldering multiple myeloma convert to active? What's the timeframe for conversion? My original oncologist said 20 months to 20yrs, i'd like something more specific. What causes smoldering to go into active? Are there preventative measures that can be taken to slow down or halt the progression? Not just the usually dietary and exercise and other healthy lifestyle advice. I mean specific to multiple myeloma.
thanks in advance for your help.
ps: is there a difference between smoldering and asymptomatic multiple myeloma?
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Re: Smoldering multiple myeloma - articles about it?
Hi SKB,
The Beacon has published a number of articles with information on smoldering myeloma. I think you'll find some of your questions answered in what's covered in those articles. See this link for the articles at the Beacon that come up after a search on the keyword combination "smoldering myeloma" .
Also, this article rather clearly indicates that "smoldering" and "asymptomatic" are just two different words for the same kind of myeloma.
Additionally, there are several related discussions on smoldering myeloma in these forums (prognosis and triggers).
The Beacon has published a number of articles with information on smoldering myeloma. I think you'll find some of your questions answered in what's covered in those articles. See this link for the articles at the Beacon that come up after a search on the keyword combination "smoldering myeloma" .
Also, this article rather clearly indicates that "smoldering" and "asymptomatic" are just two different words for the same kind of myeloma.
Additionally, there are several related discussions on smoldering myeloma in these forums (prognosis and triggers).
Re: Smoldering Multiple Myeloma
There are many good articles on smoldering myeloma. The most recent one was in the New England Journal of Medicine (full text) by Dr. Kyle and his colleagues at Mayo Clinic.
The timing of progression of smoldering myeloma to active disease is on the average of about 10% per year for the first 5 years, about 7% per year for the next 5 years and about 3% per year after that.
In general, outpatients are treated with monthly Zometa (zoledronic acid) therapy, assuming they have any evidence of bone loss on X-rays or bone density testing.
Otherwise, we do not recommend any other treatment. We have done a study with oral Celebrex (celecoxib) which appears to be promising, but this was not a randomized study comparing patients who received the drug vs. placebo.
The timing of progression of smoldering myeloma to active disease is on the average of about 10% per year for the first 5 years, about 7% per year for the next 5 years and about 3% per year after that.
In general, outpatients are treated with monthly Zometa (zoledronic acid) therapy, assuming they have any evidence of bone loss on X-rays or bone density testing.
Otherwise, we do not recommend any other treatment. We have done a study with oral Celebrex (celecoxib) which appears to be promising, but this was not a randomized study comparing patients who received the drug vs. placebo.
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Dr. James Berenson - Name: James R. Berenson, M.D.
Re: Smoldering multiple myeloma - articles about it?
I was also wondering whether smoldering myeloma, asymptomatic myeloma, and indolent myeloma are the same? If there are subtle differences between any of these, are there any sources out there that explain the differences?
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smoldering Frank - Name: Frank
- When were you/they diagnosed?: Jan 22, 2010
- Age at diagnosis: 56
Re: Smoldering multiple myeloma - articles about it?
According to Dr. S. Vincent Rajkumar of the Mayo Clinic,
"The terms smoldering and asymptomatic refer to the same type of myeloma. Smoldering multiple myeloma is a premalignant stage of myeloma. It is defined by presence of 10% or more clonal plasma cells in the marrow and/or 3 grams or greater level of IgG or IgA monoclonal protein, plus no evidence of end organ damage (anemia, hypercalcemia, bone lesions, or renal failure) that can be attributed to the plasma cell disorder. It is more advanced than MGUS, and unlike MGUS which has a 1% per year risk of progression, the risk of progression in smoldering multiple myeloma is higher at 10% per year.
The term indolent myeloma is not recommended to be used. In the past it referred to patients with myeloma who had mild end organ damage. But we consider these patients as myeloma and treat them now."
"The terms smoldering and asymptomatic refer to the same type of myeloma. Smoldering multiple myeloma is a premalignant stage of myeloma. It is defined by presence of 10% or more clonal plasma cells in the marrow and/or 3 grams or greater level of IgG or IgA monoclonal protein, plus no evidence of end organ damage (anemia, hypercalcemia, bone lesions, or renal failure) that can be attributed to the plasma cell disorder. It is more advanced than MGUS, and unlike MGUS which has a 1% per year risk of progression, the risk of progression in smoldering multiple myeloma is higher at 10% per year.
The term indolent myeloma is not recommended to be used. In the past it referred to patients with myeloma who had mild end organ damage. But we consider these patients as myeloma and treat them now."
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