Overview
Multiple myeloma (MM) is a plasma cell malignancy characterized by the proliferation of abnormal plasma cells in the bone marrow 1. Asymptomatic multiple myeloma, also known as smoldering multiple myeloma (SMM), is a precursor stage of MM that does not present with myeloma-defining events or end-organ damage 1.Diagnosis
Diagnosis of MM requires the presence of a serum or urine M-protein, bone marrow plasma cell clonality, and one or more myeloma-defining events (CRAB criteria: hypercalcemia, renal insufficiency, anemia, bone lesions) or SMM with specific biomarkers 1.
Diagnostic workup includes serum protein electrophoresis (SPEP), urine protein electrophoresis (UPEP), serum free light chain assay, bone marrow biopsy, skeletal survey or other imaging, and assessment of calcium, creatinine, and complete blood count 1.Management
Management strategies for asymptomatic multiple myeloma are not detailed in the provided abstracts. The NCCN Guidelines focus on systemic therapy for newly diagnosed and previously treated MM 1.Special Populations
Information regarding special populations (pregnancy, pediatrics, elderly, comorbidities) is not covered in the provided abstracts.Key Recommendations
The NCCN Guidelines for Multiple Myeloma provide recommendations for diagnosis, initial workup, treatment, follow-up, and supportive care 1. (Evidence: Expert opinion)
Updates in Version 1.2025 of the NCCN Guidelines for MM highlight important changes specific to systemic therapy for patients with newly diagnosed as well as previously treated MM 1. (Evidence: Expert opinion)References
1 Kumar SK, Callander NS, Adekola K, Anderson LD, Baljevic M, Baz R et al.. NCCN Guidelines® Insights: Multiple Myeloma, Version 1.2025. Journal of the National Comprehensive Cancer Network : JNCCN 2025. link