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Prashant Kapoor, MD, FACP


Understanding the Clinical Impact of Progressive Smoldering Multiple Myeloma

By: Joshua D. Madera, MD
Posted: Wednesday, February 14, 2024

The progression of smoldering multiple myeloma to active multiple myeloma may lead to a decreased disease burden and improved progression-free survival and overall survival for patients compared with patients with newly diagnosed multiple myeloma, according to a real-life, multicenter, retrospective cohort study presented at the 2023 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 4728). This reduced burden may be explained by effective disease monitoring and earlier therapeutic intervention, suggested Yael C. Cohen, MD, of Tel Aviv University, Israel, and colleagues.

From 2008 to 2023, 114 patients with multiple myeloma were included in this case-control study. Patients either had smoldering multiple myeloma that progressed to active multiple myeloma (n = 57, cohort A) or newly diagnosed multiple myeloma (n = 57, cohort B). Patients in each treatment group were matched by age and year of diagnosis and followed regularly to assess clinical outcomes.

The study findings revealed an increased progression-free survival rate for patients in cohort A (39.6 months) compared with cohort B (21.6 months). Similarly, the overall survival was increased in cohort A (not reached) compared with cohort B (93.7 months). In addition, patients from both cohorts had comparable rates of very good partial response (52.4% for cohort A vs 47.6% for cohort B). Furthermore, patients in cohort B had significantly increased bone pain, detrimental bone disease, and pathologic fractures compared with patients in cohort A. Moreover, those in cohort B had increased rates of hospital admissions for upfront therapy initiation (n = 18) compared with members of cohort A (n = 7).

Disclosure: For full disclosures of the study authors, visit

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