Smoldering Multiple Myeloma
by: Pethema • 2
Smoldering Multiple Myeloma (SMM) app is a mobile application allowing healthcare professionals to calculate the SMM risk level on the basis of an algorithm combining the following parameters:
(1) Percentage of bone marrow plasma cell (BMPC) infiltration;
(2) Immunoglobulin level (based on either IgG level, IgA level, or Bence Jones (BJ) protein level);
(3) Percentage of phenotypically aberrant plasma cells in the bone marrow plasma cell compartment;
(4) Percentage of reductions in one or two uninvolved immunoglobulins.
The way in which the above-listed parameters should be combined and the threshold values which they require are described as follows in the paper “Lenalidomide plus dexamethasone for high-risk Smoldering Multiple Myeloma”, published by Mateos (et al.) in the New England Journal of Medicine (2013, 369:438-447):
“High-risk disease was defined as plasma-cell bone marrow infiltration of at least 10% and a monoclonal component (defined as an IgG level of ≥3 g per deciliter, an IgA level of ≥2 g per deciliter, or a urinary Bence Jones protein level of >1 g per 24 hours) or only one of the two criteria described above, plus at least 95% phenotypically aberrant plasma cells in the bone marrow plasma-cell compartment, with reductions in one or two uninvolved immunoglobulins of more than 25%, as compared with normal values”.
On the basis of the above-described parameters and values, resulting from blood tests and urinary tests (BJ index), the SMM app will calculate whether a patient is “high risk SMM”, “not high risk SMM”, or has progressed to MM (Multiple Myeloma).