Targeting the tumor and the immune system in smoldering multiple myeloma
Abstract
Multiple myeloma is preceded by an asymptomatic expansion of clonal plasma cells that is detected clinically and described as smoldering multiple myeloma. Studies have identified a fraction of cases of smoldering multiple myeloma that are characterized by a high risk of early progression to multiple myeloma. Progression to multiple myeloma is associated with organ damage such as lytic lesions, bone marrow failure, and kidney failure, and studies have aimed to define strategies of early intervention for the prevention of organ damage and improvement of clinical outcomes. In this context, two approaches have been tested: eradication and containment. With the first . . .
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An early transformed clone acquires additional genomic events that lead to its expansion.
“This clearly supports a model where an early transformed clone acquires additional genomic events that lead to its expansion.85”
From Evolution of Multiple Myeloma from a Genomic Perspective (2026) · cites this paper as [85]
Neoplastic transformation occurs early in time.
“suggesting that the neoplastic transformation occurs early in time.9,11,79,80,85”
From Evolution of Multiple Myeloma from a Genomic Perspective (2026) · cites this paper as [85]
Patterns of genomic complexity and neoplastic transformation can already be observed in some MGUS and low-risk SMM cases several years before progression.
“Interestingly, these patterns of genomic complexity and neoplastic transformation can already be observed in some MGUS and low-risk SMM cases several years before progression, suggesting that the neoplastic transformation occurs early in time.9,11,79,80,85”
From Evolution of Multiple Myeloma from a Genomic Perspective (2026) · cites this paper as [85]
In patients with both IGH translocation and HY, the HY is acquired 20 years before diagnosis and always after IGH translocations.
“it has been shown that in patients with both IGH translocation and HY, the HY is acquired 20 years before diagnosis and always after IGH translocations.”
From Evolution of Multiple Myeloma from a Genomic Perspective (2026) · cites this paper as [85]
Cites
MYC dysregulation in the progression of multiple myeloma
MMRF CoMMpass Network, Misund, K., Keane, N., Stein, C. K., Asmann, Y. W., Day, G., Welsh, S., Van Wier, S. A., Riggs, D. L., Ahmann, G., et al. (2020) · Leukemia · doi:10.1038/s41375-019-0543-4 · Cited by 161 · see citing works
Self-citationGenomic Classification and Individualized Prognosis in Multiple Myeloma
Maura, F., Rajanna, A. R., Ziccheddu, B., Poos, A. M., Derkach, A., Maclachlan, K., Durante, M., Diamond, B., Papadimitriou, M., Davies, F., et al. (2024) · Journal of Clinical Oncology · doi:10.1200/jco.23.01277 · Cited by 131 · see citing works
Self-citationRobinson, M. H., Villa, N. Y., Jaye, D. L., Nooka, A. K., Duffy, A., McCachren, S. S., Manalo, J., Switchenko, J. M., Barnes, S., Potdar, S., et al. (2023) · Journal of Clinical Investigation · doi:10.1172/jci167629 · Cited by 48 · see citing works
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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
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- Authors
- Maura, F., & Bergsagel, P. L.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Mayo Clinic in Arizona (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2025-05-08
- Volume
- 392
- Issue
- 18
- Pages
- 1858-1860
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W4410141758
- Cited by
- 5
- References
- 3
- Citations by year
- 2026: 2 · 2025: 3
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
- Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
- Health Sciences › Medicine › Oncology › Bone health and treatments
- Keywords
- smoldering multiple myeloma, progression to multiple myeloma, clonal plasma cells, organ damage, osteolytic lesions, bone marrow failure, renal failure, early intervention, eradication therapy, tumor immunology, immune system
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