Evolving Definitions and Risk Gaps in High-Risk Smoldering Multiple Myeloma
Explore the evolving landscape of high-risk smoldering myeloma treatment options and the challenges in patient management and risk assessment.
This segment focuses on how high-risk smoldering multiple myeloma is currently defined and the challenges clinicians face when applying existing risk-stratification models in practice. Faculty review commonly used frameworks, including Mayo, IMWG, and PETHEMA criteria, and discuss how variability among these models can lead to uncertainty in identifying patients most likely to benefit from early intervention.
Panelists explore gaps in current risk definitions, such as biological heterogeneity, limitations in predicting individual patient trajectories, and the difficulty of distinguishing truly high-risk disease from more indolent cases. The discussion emphasizes how these uncertainties have historically contributed to continued reliance on observation, despite an appreciable risk of early progression in certain patients.
By highlighting where existing risk models fall short, this segment underscores the clinical need for more precise risk assessment and sets the foundation for understanding how recent trial designs, including AQUILA, attempted to address these challenges through more rigorous patient selection.
