Smouldering myeloma
Patients with smouldering myeloma are diagnosed on the basis of:
- ≥30 g/L serum paraprotein
- More than 10% but less than 60% plasma cells in bone marrow
- No myeloma-defining events or symptoms of myeloma
Smouldering myeloma patients are not usually treated until there is evidence of progression to myeloma. Many patients do not progress for months or years but are monitored closely and should be risk stratified where possible, using the Mayo and/or IMWG 2/20/20 models. The diagnosis can still have a strong emotional and psychological impact on patients. Nurses play an important role in supporting these patients through what can be an uncertain and difficult time and advising them of symptoms to look out for that may indicate progression.