Asymptomatic Myeloma Prognosis

Risk stratification of asymptomatic (smoldering) myeloma

Risk groupMarrow plasma cells (%)M protein level (g/L)Median TTP (y)
Low< 10> 3019
Inter­mediate≥ 10< 308
High≥ 10≥ 302

This risk stratification system was developed from a retrospective analysis of 276 patients with asymptomatic (smoldering) myeloma diagnosed between 1970 and 1995.1 Over a median follow-up of 11.6 years, 57% of patients developed symptomatic myeloma and 2% developed amyloidosis. On multivariate analysis, only M protein level and bone marrow plasma cell percentage were associated with time to progression.

M protein: monoclonal protein (paraprotein)
TTP: time to progression