Smoldering myeloma

 High risk smoldering

20/2/20

• BM clonal plasma cells 20% or higher
• M spike 2 gm or higher
• FLC involved to uninvolved 20 or higher.

Any 2 of the above: high risk SMM

The 2-year progression rate for high-risk patients is 46%.

Aquila trial- 

Overall survival at 5 years was 93.0% with daratumumab and 86.9% with active monitoring. The most common grade 3 or 4 adverse event was hypertension, which occurred in 5.7% and 4.6%