[Inchool]

What determines high-risk smoldering myeloma?

by Inchool on Wed Mar 31, 2010 4:36 am

Relating to an article by Francie Diep posted on The Myeloma Beacon on 12-23-09, "Preemptive Treatment Benefits High-Risk, Smoldering Myeloma Patients, Study Finds (ASH 2009)":

If you've been diagnosed with smoldering multiple myeloma, how is it determined specifically that the you do - or don't - have the high-risk type?

What specific blood tests -- and what values -- determine the high-risk type?

Thank you very much, Dr. Lacy.

[Beacon Staff]

What determines high-risk smoldering myeloma?

by Beacon Staff on Sat Apr 03, 2010 4:55 pm

Dr. Martha Lacy from the Mayo Clinic said:

"The study you refer to was presented at ASH in December. To be eligible patients had to have high risk smoldering multiple myeloma and have at least one of the following:

1. Both bone marrow plasma cells ≥10% & m-spike≥3g/dl, or
2. 95% or greater aberrant PC (aPC) by immunophenotyping, or
3. Abnormal immunoglobulin free light chain (FLC) ratio

Patients with any of these characteristics have a higher risk of progressing to active multiple myeloma.
The study was exciting because it showed that patients treated with lenalidomide [Revlimid] and dexamethasone (len/dex) have less risk of progressing to active multiple myeloma.

However, it is too early to advocate this approach for everyone with smoldering multiple myeloma because the real test is 'Does delaying progression to active multiple myeloma result in living longer?' If you use len/dex at the smoldering multiple myeloma stage does that eliminate that regimen as an active combination later when the myeloma is active?

As this study matures, hopefully we will find the answer."