Smoldering multiple myeloma (SMM) is an asymptomatic precursor to active multiple myeloma (MM). The aim of this study was to report clinical characteristics and outcomes of patients with SMM stratified based on their risk of progression to MM using the Mayo 20/2/20 criteria. Data were leveraged from the Czech Myeloma Group Registry of Monoclonal Gammopathies (RMG). Key outcomes included progression-free survival from SMM diagnosis to active MM diagnosis or death (PFS), progression-free survival from SMM diagnosis to progression on first line (1 L) MM treatment or death (PFS2), and overall survival (OS). Of 498 patients, 174 (34.9%) were classified as high risk and 324 (65.1%) as non–high risk. Median follow-up was approximately 65 months. During follow-up, more patients in the high-risk vs non–high-risk group received 1 L MM treatment (76.4% vs 46.6%, p < 0.001). PFS, PFS2, and OS were significantly shorter in high-risk vs non–high-risk patients (13.2 vs 56.6 months, p < 0.001; 49.9 vs 84.9 months, p < 0.001; 93.2 vs 131.1 months, p = 0.012, respectively). The results of this study add to the growing body of evidence that patients with high-risk vs non–high-risk SMM have significantly worse outcomes, including OS.
冒烟型多发性骨髓瘤（SMM）是活动性多发性骨髓瘤（MM）的无症状前期病变。本研究旨在依据Mayo 20/2/20危险分层标准，报告不同进展风险分层的SMM患者的临床特征与结局。数据来源于捷克单克隆丙种球蛋白病登记组（RMG）。关键结局指标包括：从SMM诊断至进展为活动性MM或死亡的无进展生存期（PFS）、从SMM诊断至一线（1L）MM治疗期间疾病进展或死亡的无进展生存期（PFS2）以及总生存期（OS）。在498例患者中，174例（34.9%）被划分为高危组，324例（65.1%）为非高危组。中位随访时间约为65个月。随访期间，高危组患者接受一线MM治疗的比例显著高于非高危组（76.4% vs 46.6%，p < 0.001）。高危组患者的PFS、PFS2和OS均显著短于非高危组（分别为13.2个月 vs 56.6个月，p < 0.001；49.9个月 vs 84.9个月，p < 0.001；93.2个月 vs 131.1个月，p = 0.012）。本研究结果进一步证实，与非高危SMM患者相比，高危SMM患者的临床结局（包括总生存期）显著更差。
肿瘤(癌症)患者之家