Dr. Braunstein on Reclassifying Ultra High-Risk Smoldering Multiple Myeloma

Marc J. Braunstein, MD, PhD, clinical assistant professor, Department of Medicine, co-director, Autologous Stem Cell Transplant Program,NYU Winthrop Hospital, NYU Langone Health, discusses reclassifying patients with ultra—high-risk smoldering multiple myeloma (SMM).

Patients with SMM are at risk of developing symptomatic multiple myeloma. However, not all patients with SMM carry the same risk, explains Braunstein. If patients are stratified according to their risk, investigators could define optimal intervention strategies for each subgroup. Earlier intervention, especially among ultra—high-risk patients, could lead to improved outcomes, says Braunstein.

According to the revised 2014 International Myeloma Working Group Response Criteria, ultra­—high-risk SMM is now classified as symptomatic multiple myeloma. Patients with this subtype have ≥60% plasma cells in their bone marrow, a serum free light chain ratio >100, or ≥1 lytic lesion of ≥0.5cm, explains Braunstein. These patients should be treated the same as patients with newly diagnosed multiple myeloma, concludes Braunstein.