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Smoldering Multiple Myeloma — Management
Smoldering myeloma
M-protein ≥ 3 g/dL or
10–60% plasma cells
Work-up
Low-risk SMM
High-risk SMM (20/2/20)
Stage
Marrow + FLC + whole-body MRI/CT
exclude active myeloma
Observe
Surveillance q3–6 months
no therapy
Early therapy
Lenalidomide ± daratumumab
E3A06 ↗
Trial
Daratumumab
AQUILA ↗