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May 24, 2026American Society of Clinical Oncology Educational Book

Smoldering Multiple Myeloma: From Clinical to Immunogenomic Risk Stratification and Therapeutic Implications of Early Intervention

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Authors

NBNizar J. BahlisMMMaría V. MateosANAjay K. Nooka

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Overview

Randomized trials demonstrate early intervention improves outcomes in high-risk smoldering multiple myeloma, suggesting the need for targeted therapies.

Key Points

  • This research aims to refine risk stratification in smoldering multiple myeloma (SMM) by integrating clinical and genomic factors.
  • Utilized the International Myeloma Working Group 20/2/20 model for risk stratification based on clinical criteria.
  • Identified key genomic features associated with SMM progression, including mutations in the MAPK pathway and alterations of DNA repair pathways.
  • Analyzed data from three randomized phase III studies assessing the impact of early intervention on overall survival.
  • Patients with ≥2 risk factors demonstrated a 40%-50% risk of progression to multiple myeloma within two years.
  • One study (QuiRedex) showed a significant overall survival benefit for early intervention, while another (AQUILA) indicated a trend toward improved overall survival.
  • Integration of clinical and genomic data aims to optimize identification of high-risk SMM patients for therapeutic interventions.

Cite This Study

Bahlis et al. (2026) studied this question.

synapsesocial.com/papers/6a12965848a0ea1665673133https://doi.org/10.1200/edbk-26-517488
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Genomically Smoldering Multiple Myeloma Is Not a Distinct Entity But a Collection of Monoclonal Gammopathy of Undetermined Significance or Multiple Myeloma2025 · 8 citations
  2. 2New criteria to identify risk of progression in monoclonal gammopathy of uncertain significance and smoldering multiple myeloma based on multiparameter flow cytometry analysis of bone marrow plasma cells2007 · 585 citations
  3. 3Immune status of high-risk smoldering multiple myeloma patients and its therapeutic modulation under LenDex: a longitudinal analysis2015 · 77 citations
  4. 4Whole-genome sequencing reveals progressive versus stable myeloma precursor conditions as two distinct entities2021 · 131 citations
  5. 5Frequent and specific immunity to the embryonal stem cell–associated antigen SOX2 in patients with monoclonal gammopathy2007 · 198 citations