Clinician preferences on treatment of smoldering myeloma: a cross-sectional survey

Diagnosis and management of smouldering myeloma: A British Society for Haematology Good Practice Paper

“…Cross-over to lenalidomide prior to formal progression was allowed and will limit any OS data. 112 Importantly, the rate of progression in the observation arm was low (24% in 2 years), perhaps relating to the trial amendment in 2013 allowing patients diagnosed within 5 years rather than solely at diagnosis, suggesting this was not a truly high-risk population. Additionally, grade 3 or 4 adverse events occurred in 41% of patients on lenalidomide and 20% of patients stopped treatment due to adverse effects although there was no significant decline in patient-reported health-related quality of life measures between initiation and 2 years in either group.…”

Risk stratification models overestimate progression risk in contemporary patients with smoldering multiple myeloma

“…Notably, multiple groups have proposed risk‐stratification models in SMM: the Spanish/PETHEMA model, 6 Mayo 2008, 7 Mayo 2018 (20/2/20), 8 IMWG SMM, 9 and most recently, PANGEA 10 . Additionally, two randomized trials have raised the question of whether early intervention should be recommended to patients with high‐risk SMM 11–13 . However, the models are of differing complexities, use different inputs, and produce discordant results, making it challenging to know which to use in clinical practice.…”

“… 10 Additionally, two randomized trials have raised the question of whether early intervention should be recommended to patients with high‐risk SMM. 11 , 12 , 13 However, the models are of differing complexities, use different inputs, and produce discordant results, making it challenging to know which to use in clinical practice. Furthermore, many were validated on cohorts defined by pre‐2014 criteria.…”