Smoldering Multiple Myeloma (SMM) is an asymptomatic condition, and this concept was first described by Kyle and Greipp in 1980. They described the entity as an intermediate stage between monoclonal gammopathy of undermined significance (MGUS) and multiple myeloma (MM) on the basis of their research. The typical age of diagnosis is recorded as 50 to 70 years. As this condition is asymptomatic, the newly diagnosed patients are typically diagnosed when an M protein is discovered on laboratory testing as part of the workup of a variety of disorders.
For a SMM patient at high risk, there is 50-79% of progression risk for MM or related disorder in the first 2 years. Biomarkers such as clonal plasma cell bone marrow infiltration ≥10%, serum M-protein ≥3 g/dL and/or Serum-free light chain ratio > 0.125 or <8 are clear cut indicator of higher risk.
The worldwide population of HRSMM is expected to increase at a remarkable rate in future. Among all major markets, United States is expected to have highest number of HRSMM population, growing at a higher rate, followed by other market. Based on studies and analyses, the total HRSMM population is expected to rise in certain markets and fall in other as well, in coming years.
At present, there’s no drug approved for the treatment of HRSMM. The treatment of patients with high-risk cytogenetic factors remains an area of unmet medical need mainly due to the unavailability of the specific treatment, and loopholes in the diagnosis. Misdiagnosis and delayed diagnosis is also one of the challenges in the treatment of HRSMM and improvement in the diagnostics might prove to be an important life saving effort.