Sarah S. Lee, MD, physician, Seattle Cancer Care Alliance, assistant professor, Division of Medical Oncology, University of Washington School of Medicine, assistant member, Clinical Research Division, Fred Hutchinson Cancer Research Center, discusses treatment considerations in smoldering multiple myeloma.

Because a significant amount of research is ongoing for patients with smoldering multiple myeloma, enrollment to clinical trials is often the highest priority, Lee explains. However, for high-risk patients who are ineligible for clinical trials, treatment with lenalidomide (Revlimid) may be considered.

Data from a phase 2/3 trial (NCT01169337) showed that early intervention with lenalidomide significantly delayed progression to symptomatic multiple myeloma and the development of end-organ damage vs observation in patients with smoldering multiple myeloma. Moreover, quality of life did not appear to be negatively affected with the addition of lenalidomide vs observation in this patient population, Lee concludes.

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Sarah S. Lee, MD, discusses treatment considerations in smoldering multiple myeloma.

Dr. Lee on Treatment Considerations in Smoldering Multiple Myeloma 

Sarah S. Lee, MD, physician, Seattle Cancer Care Alliance, assistant professor, Division of Medical Oncology, University of Washington School of Medicine, assistant member, Clinical Research Division, Fred Hutchinson Cancer Research Center, discusses definition criteria for smoldering multiple myeloma.

Laboratory findings, as well as bone marrow biopsy results, are used to make a diagnosis of smoldering multiple myeloma, Lee explains. The International Myeloma Working (IMW) Group recommends that all patients with suspected smoldering multiple myeloma undergo a PET-CT scan, a low-dose whole body CT scan, or an MRI of the whole body or spine.

Per the IMW Group criteria, patients with smoldering myeloma must have a serum monoclonal protein of at least 30 g/L or a urinary monoclonal protein of at least 500 mg/day and/or clonal bone marrow plasma cells of 10% to 60%, Lee says. 

Additionally, patients must not have any myeloma-defining events or amyloidosis, Lee concludes.

Sarah S. Lee, MD, discusses definition criteria for smoldering multiple myeloma.  



Sarah S. Lee, MD

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Dr. Lee on Treatment Considerations in Smoldering Multiple Myeloma

Dr. Lee on Defining Smoldering Multiple Myeloma