Smouldering myeloma, also known as smoldering myeloma, indolent myeloma or asymptomatic myeloma, is a disease which is characterised by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein (M protein). In some patients, smouldering myeloma can progress to a malignant disease called multiple myeloma. Smouldering myeloma is characeterised by the lack of symptoms but a bone marrow biopsy shows presence of myeloma cells.
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Diagnosis
Smouldering myeloma is characterised by:
Prognosis
Smouldering myeloma with an increasingly abnormal serum free light chain (FLC) ratio is associated with a higher risk for progression to active multiple myeloma.
Treatment
Treatment for multiple myeloma is focused on therapies that decrease the clonal plasma cell population and consequently decrease the signs and symptoms of disease. If the disease is completely asymptomatic (i.e. there is a paraprotein and an abnormal bone marrow population but no end-organ damage), as in smoldering myeloma, treatment is typically deferred, or restricted to clinical trials.
They are generally responsive to IL-1β neutralisation.