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IMS 2024 | The future of managing precursor conditions
Kwee Yong, PhD, FRCP, FRCPath, University College London, London, UK, discusses her vision for the future of managing precursor conditions such as smoldering multiple myeloma (SMM). Prof. Yong highlights the importance of improving risk stratification to ensure that those at high risk of progression to multiple myeloma (MM) are treated appropriately. This interview took place at the 21st International Myeloma Society (IMS) Annual Meeting, held in Rio de Janeiro, Brazil.
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Transcript
So a watch and wait strategy is currently our standard of care for all the reasons we discuss and all the uncertainties. Looking to the future, what I envisage and would be wonderful if it happened is if we could stratify our patients for different levels of management. There’s a group of patients with smoldering myeloma who really have MGUS. They are highly unlikely to progress, at least for the duration of their lifetime...
So a watch and wait strategy is currently our standard of care for all the reasons we discuss and all the uncertainties. Looking to the future, what I envisage and would be wonderful if it happened is if we could stratify our patients for different levels of management. There’s a group of patients with smoldering myeloma who really have MGUS. They are highly unlikely to progress, at least for the duration of their lifetime. And they should be monitored as MGUS and perhaps returned to the care of their primary care doctor. There’s another group of patients with all the high-risk features and the hallmarks of what is really multiple myeloma. They just haven’t declared themselves with organ damage yet. They should be treated as multiple myeloma. It’s the intervening group, the patients who do not yet have myeloma but have some features predictive of progression from smoldering myeloma that we really need to figure out what are the best strategies to prevent progression.
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