Smoldering Myeloma

Authored by Vincent Rajkumar, published on 2026-03-24 02:45:15.0

Treatment algorithm for smoldering myeloma. Incorporates the 2025 Daratumumab FDA approval for high risk smoldering myeloma. Active drugs in multiple myeloma reference.mSMART 4.0 Risk Stratification of active multiple myeloma.

  1. Potential New Myeloma or Smoldering Myeloma
    • Any Myeloma Defining Events?
      • Treat as Myeloma
    • No Myeloma Defining Events (SMM)
      • Intermediate or Low Risk SMM
        • Observation
      • High Risk SMM (Median TTP ~2 years)
        • High Risk SMM or Evolving SMM
          • Daratumumab x 3 years*
        • Clinical Trials
tosprivacySmoldering multiple myeloma current treatment algorithmsDaratumumab or Active Monitoring for High-Risk Smoldering Multiple MyelomaLenalidomide plus Dexamethasone for High-Risk Smoldering Multiple MyelomaRandomized Trial of Lenalidomide Versus Observation in Smoldering Multiple Myeloma