Smouldering myeloma

What is smouldering myeloma?

Smouldering myeloma is an early form of the blood cancer myeloma. In smouldering myeloma abnormal cells can be detected in the bone marrow, and abnormal protein can be detected in the blood and/or urine. However, smouldering myeloma patients usually have none of the typical symptoms related to active myeloma and generally do not require treatment.

Smouldering myeloma patients are monitored regularly for signs that may indicate that they are developing active myeloma or related conditions, which do need treatment.

People with smouldering myeloma usually develop active myeloma at some time, but how long this takes varies. Sometimes, smouldering myeloma stays unchanged and never develops into active myeloma. Occasionally it may develop into another condition called AL amyloidosis.

How is smouldering myeloma diagnosed?

Because smouldering myeloma does not normally cause symptoms it is usually diagnosed by chance, following a routine health check or blood tests for another condition. Blood tests will show an increased level of overall protein and this will usually prompt further investigation.

To establish the diagnosis, various tests and investigations are carried out including blood and/or urine tests, imaging tests and a bone marrow biopsy.

People with a related condition called MGUS (monoclonal gammopathy of undetermined significance) are regularly tested for early signs of myeloma and smouldering myeloma.

What is the treatment for smouldering myeloma?

Currently, smouldering myeloma is not generally treated. This is because the benefit of treatment is not certain, and may be outweighed by the risks of potential side-effects.

Further reading