Assessment of Discordance Among Smoldering Multiple Myeloma Risk Models
Open accessAbstract
This cohort study assesses the concordance of 3 models to stratify risk for progression to multiple myeloma in an independent cohort of patients with smoldering multiple myeloma.
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Some groups have investigated the use of lenalidomide or daratumumab to enhance immune control of high-risk clones.
“As an alternative strategy to eradication, some groups have investigated the use of lenalidomide or daratumumab to enhance immune control of high-risk clones.107,111”
From Evolution of Multiple Myeloma from a Genomic Perspective (2026) · cites this paper as [111]
The Abstract (page not available in our copy) says that multiple clinical trials are investigating treatment for high-risk smoldering multiple myeloma. It does not identify lenalidomide or daratumumab or say that these treatments aim to enhance immune control of high-risk clones. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSeveral trials have reported the advantages and risks of early intervention in high-risk SMM.
“Several trials have reported the advantages and risks of early intervention in high risk SMM.105-112”
From Evolution of Multiple Myeloma from a Genomic Perspective (2026) · cites this paper as [111]
The Abstract (no page provided) says multiple clinical trials are investigating treatment in high-risk SMM. It does not say that those trials have reported advantages and risks of early intervention; the Discussion instead says it remains unclear which patients warrant early intervention. (LLM, conf=0.82)
Experimental — accuracy not yet measuredAll randomized studies (excluding active MM) show a clear advantage in progression-free survival, delaying MM progression, and preventing symptoms/organ damage; a recent study shows an overall survival advantage of early treatment.
“Excluding patients with an active MM according to the most recent guidelines,3 all randomized studies have shown a clear advantage in progression-free survival, in delaying MM progression, in preventing symptoms/organ damage,107-109 and a recent study has also demonstrated the overall survival (OS) advantage of early treatment,111”
From Evolution of Multiple Myeloma from a Genomic Perspective (2026) · cites this paper as [111]
The Abstract describes trials investigating treatment for high-risk smoldering multiple myeloma, but this paper assesses agreement among risk models, not treatment outcomes. The Methods and Discussion report no progression-free or overall survival advantage, delay in progression, or prevention of symptoms or organ damage; searches for early-treatment and survival outcomes found no such passage. (LLM, conf=0.76)
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Research works printed but not linked: 6
- [1]Landgren O, Kyle RA, Pfeiffer RM, et al. Monoclonal gammopathy of undetermined significance (MGUS) consistently precedes multiple myeloma: a prospective study. Blood. 2009;113(22):5412-5417. doi: 10.1182/blood-2008-12-194241 [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI · Paper page
- [2]Pérez-Persona E, Vidriales MB, Mateo G, et al. New criteria to identify risk of progression in monoclonal gammopathy of uncertain significance and smoldering multiple myeloma based on multiparameter flow cytometry analysis of bone marrow plasma cells. Blood. 2007;110(7):2586-2592. doi: 10.1182/blood-2007-05-088443 [DOI] [PubMed] [Google Scholar] · DOI · Paper page
- [3]Lakshman A, Rajkumar SV, Buadi FK, et al. Risk stratification of smoldering multiple myeloma incorporating revised IMWG diagnostic criteria. Blood Cancer J. 2018;8(6):59-59. doi: 10.1038/s41408-018-0077-4 [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
- [4]Hill E, Dew A, Kazandjian D. State of the science in smoldering myeloma: should we be treating in the clinic? Semin Oncol. 2019;46(2):112-120. doi: 10.1053/j.seminoncol.2019.03.001 [DOI] [PubMed] [Google Scholar] · DOI
- [5]Zamagni E, Nanni C, Gay F, et al. 18F-FDG PET/CT focal, but not osteolytic, lesions predict the progression of smoldering myeloma to active disease. Leukemia. 2016;30(2):417-422. doi: 10.1038/leu.2015.291 [DOI] [PubMed] [Google Scholar] · DOI
- [6]Maura F, Bolli N, Rustad EH, Hultcrantz M, Munshi N, Landgren O. Moving from cancer burden to cancer genomics for smoldering myeloma: a review. JAMA Oncol. 2020;6(3):425-432. doi: 10.1001/jamaoncol.2019.4659 [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
Cited by
Sorted by citations
Termini, R., Žihala, D., Terpos, E., Perez-Montaña, A., Jelínek, T., Raab, M., Weinhold, N., Mai, E. K., Grab, A. L., Corre, J., et al. (2022) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-22-1594 · Cited by 54 · see citing works
Evolution of Multiple Myeloma from a Genomic Perspective
Maura, F., Samur, M., & Munshi, N. (2026) · Blood · doi:10.1182/blood.2024026313 · Cited by 8 · see citing works
- Authors
- Hill, E., Dew, A., Morrison, C., Yuan, C., Stetler-Stevenson, M., Landgren, O., & Kazandjian, D.
- Affiliations
- National Institutes of Health (US)
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
- Memorial Sloan Kettering Cancer Center (US)
- Corresponding author
- Kazandjian, Dickran
- Venue
- JAMA Oncology
- Publisher
- American Medical Association (AMA)
- Published
- 2021-01-01
- Volume
- 7
- Issue
- 1
- Pages
- 132
- ISSN
- 2374-2437 (ISSN-L)
- PMC
- PMC7677870
- OpenAlex
- W3100238998
- Cited by
- 43
- References
- 0
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 11 · 2023: 9 · 2022: 6 · 2021: 7
- FWCI
- 3.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Oncology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (P30CA008748)
- Topics
- Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
- Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
- Health Sciences › Medicine › Epidemiology › Multiple and Secondary Primary Cancers
- Keywords
- smoldering multiple myeloma, progression to multiple myeloma, risk prediction model, risk stratification
- MeSH terms
- Smoldering Multiple Myeloma, Humans, Monoclonal Gammopathy of Undetermined Significance, Multiple Myeloma, Disease Progression
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