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

Abstract

This good practice paper was compiled according to the British Society for Haematology (BSH) process at (https:// b-s-h. org. uk/ media/ 16732/ bsh-guida nce-devel opmen tproce ss-dec-5-18. pdf). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) nomenclature was used to evaluate the levels of evidence and to assess the strength of recommendations. The BSH produces good practice papers to recommend good practice in areas where there is a limited evidence base, but for which a degree of consensus or uniformity is likely to be beneficial to patient care. Literature review detailsA literature search was performed using the EMBASE and MEDLINE databases using the following search terms: monoclonal gammopathy of undetermined significance, multiple myeloma, smouldering (smoldering) multiple myeloma; monoclonal gammopathy, MGUS. Review of the manuscriptReview of the manuscript was performed by the BSH Haemato-Oncology Task Force, the BSH Guidelines Committee and the Haemato-Oncology sounding board of BSH. It has also been reviewed by the UK Myeloma Society and Myeloma UK. I N TRODUC TIONMultiple myeloma (MM) is a clonal bone marrow disorder of plasma cells. MM is preceded by the precursor conditions monoclonal gammopathy of undetermined significance (MGUS) and smouldering myeloma (SMM). SMM sits between MGUS and MM, representing a plasma