Definitions of SMM (asymptomatic)/IMM/evolving MM
| Reference . | n . | % BMPCs, (M protein, g/L), [other criteria] . | Risk factors . | Median TTP and OS . |
|---|---|---|---|---|
| Kyle and Greipp, 19801 | 6 | ≥10, (and ≥ 30), [no anemia, hypercalcemia, or renal insufficiency] | Not available | Selected for no progression at 5 y |
| Alexanian et al, 19883 | 35 | ≥10, (and > 20 but < 45 g/L), [hemoglobin > 10.5 g/dL] | Asymptomatic lytic bone lesions (n = 10), M protein > 30 g/L | TTP all: 19 mo; TTP no bone: 25 mo; OS all: 105 mo; OS no bone: 125 mo |
| IMWG, 20032 | ≥10, (or ≥ 30 g/L), [absence of: high calcium, hemoglobin 2 g/dL below normal or < 10 g/dL, lytic bone lesions or osteoporosis with compression fracture, symptomatic hyperviscosity, amyloidosis, or > 2 bacterial infections/12 mo] | Not available | ||
| DSS IA18,19 | Not stated, (IgG < 50 g/L, IgA < 30 g/L, or urine M component < 4 g/24 h), [hemoglobin > 10 g/dL, calcium < 12 mg/dL, no more than solitary bone lesion] | Not available | OS: 69 mo76 | |
| DSS IIA18,19 | Not stated, (immunoglobulins higher than stage I), [hemoglobin > 8.5 but < 10 g/dL, calcium < 12 mg/dL, more than a solitary bone lesion, but not advanced bone disease] | Not available | OS: 58 mo76 | |
| Alexanian et al, 198016 | 20 | “Indolent MM”: ≥ 15%, (and IgG > 25 g/L or IgA > 10 g/L), [Hb >10.0 g/dL; < 3 lytic bone lesions; no painful compression fracture] | Not available | TTP: 28 mo; OS from IMM: 64 mo; OS from treatment: 36 mo |
| Alexanian et al, 19883 | 16 | Indolent MM ≥ 10 (and ≥ 45 g/dL), [or Hb < 10.5] | Not available | 8 mo |
| Rosinol et al, 200317 | 53 | Evolving MM ≥ 10, (and ≥ 30 g/L or light chain excretion 1 g/24 h), [hemoglobin > 10 g/dL, no bone lesions, renal, or hypercalcemia] | Evolving (n = 22), nonevolving (n = 26); trend toward hemoglobin < 12 g/dL and M protein > 35 g/L were risk factors | TTP nonevolving: 47 mo; TTP evolving: 16 mo; OS from dexamethasone: 98 mo; OS from treatment: 42 mo |
| Cesana et al, 200277 | 127 | 1-y stability required 11%-19%, (or IgG 35-69 g/L, IgA 21-69 g/L, Bence Jones proteinuria 1 g/24 h), [no bone lesions, anemia, hypercalcemia, and renal insufficiency] | BMPC > 10%; IgA M protein; proteinuria | Not given |
| Reference . | n . | % BMPCs, (M protein, g/L), [other criteria] . | Risk factors . | Median TTP and OS . |
|---|---|---|---|---|
| Kyle and Greipp, 19801 | 6 | ≥10, (and ≥ 30), [no anemia, hypercalcemia, or renal insufficiency] | Not available | Selected for no progression at 5 y |
| Alexanian et al, 19883 | 35 | ≥10, (and > 20 but < 45 g/L), [hemoglobin > 10.5 g/dL] | Asymptomatic lytic bone lesions (n = 10), M protein > 30 g/L | TTP all: 19 mo; TTP no bone: 25 mo; OS all: 105 mo; OS no bone: 125 mo |
| IMWG, 20032 | ≥10, (or ≥ 30 g/L), [absence of: high calcium, hemoglobin 2 g/dL below normal or < 10 g/dL, lytic bone lesions or osteoporosis with compression fracture, symptomatic hyperviscosity, amyloidosis, or > 2 bacterial infections/12 mo] | Not available | ||
| DSS IA18,19 | Not stated, (IgG < 50 g/L, IgA < 30 g/L, or urine M component < 4 g/24 h), [hemoglobin > 10 g/dL, calcium < 12 mg/dL, no more than solitary bone lesion] | Not available | OS: 69 mo76 | |
| DSS IIA18,19 | Not stated, (immunoglobulins higher than stage I), [hemoglobin > 8.5 but < 10 g/dL, calcium < 12 mg/dL, more than a solitary bone lesion, but not advanced bone disease] | Not available | OS: 58 mo76 | |
| Alexanian et al, 198016 | 20 | “Indolent MM”: ≥ 15%, (and IgG > 25 g/L or IgA > 10 g/L), [Hb >10.0 g/dL; < 3 lytic bone lesions; no painful compression fracture] | Not available | TTP: 28 mo; OS from IMM: 64 mo; OS from treatment: 36 mo |
| Alexanian et al, 19883 | 16 | Indolent MM ≥ 10 (and ≥ 45 g/dL), [or Hb < 10.5] | Not available | 8 mo |
| Rosinol et al, 200317 | 53 | Evolving MM ≥ 10, (and ≥ 30 g/L or light chain excretion 1 g/24 h), [hemoglobin > 10 g/dL, no bone lesions, renal, or hypercalcemia] | Evolving (n = 22), nonevolving (n = 26); trend toward hemoglobin < 12 g/dL and M protein > 35 g/L were risk factors | TTP nonevolving: 47 mo; TTP evolving: 16 mo; OS from dexamethasone: 98 mo; OS from treatment: 42 mo |
| Cesana et al, 200277 | 127 | 1-y stability required 11%-19%, (or IgG 35-69 g/L, IgA 21-69 g/L, Bence Jones proteinuria 1 g/24 h), [no bone lesions, anemia, hypercalcemia, and renal insufficiency] | BMPC > 10%; IgA M protein; proteinuria | Not given |