Smoldering Myeloma

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Use this calculator to determine prognosis in smoldering multiple myeloma.

Bone marrow plasmacytosis
M-protein size

About this calculator

Smoldering or asymptomatic multiple myeloma (SMM) is a plasma cell dyscrasia characterized by a serum monoclonal protein level of 30 g/L or more or a proportion of plasma cells in the bone marrow of 10% or more but no evidence of end-organ damage. Individuals with SMM have a high-risk of progression to future symptomatic multiple myeloma or amyloidosis. A study from the Mayo Clinic followed 276 patients with SMM over a 26-year study period to establish prognostic factors for progression. The risk of progression was not constant over time. The overall risk of progression was 10% per year for the first 5 years, approximately 3 % per year for the next 5 years, and 1% per year for the last 10 years; the cumulative probability of progression was 73% at 15 years. The proportion of plasma cells in the bone marrow and the serum monoclonal protein concentration were combined to create a risk-stratification model with three distinct prognostic groups.


This model was developed by:

Kyle RA, Remstein ED, Therneau TM, Dispenzieri A, Kurtin PJ, Hodnefield JM, Larson DR, Plevak MF, Jelinek DF, Fonseca R, Melton LJ 3rd, Rajkumar SV. Clinical course and prognosis of smoldering (asymptomatic) multiple myeloma. N Engl J Med. 2007 Jun 21;356(25):2582-90. PMID: 17582068.


QxMD Hematology contributing author: Dr. Matthew Cheung, MD, SM, FRCP(C)