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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    Asymptomatic Myeloma Prognosis

    Predicts risk of progression of asymptomatic (smoldering) multiple myeloma to active myeloma or amyloidosis.
    When to Use
    Pearls/Pitfalls
    Why Use

    Newly diagnosed multiple myeloma (MM) patients meeting International Myeloma Working Group criteria for smoldering or asymptomatic MM (see Pearls/Pitfalls for criteria).

    The Asymptomatic Myeloma Prognosis calculator classifies smoldering multiple myeloma (MM) patients into 3 prognostic groups, with differing risks of progression to active MM or amyloidosis.

    The criteria developed by the International Myeloma Working Group for diagnosis of smoldering multiple myeloma (SMM, or asymptomatic MM) are:

    1. Serum monoclonal protein ≥3 g/dL OR
    2. Plasma cells in bone marrow (BM) ≥ 10% AND
    3. No evidence of end-organ damage (no anemia, bone lesions, renal dysfunction, hypercalcemia, or recurrent bacterial infections)

    Prognosis and risk for progression to MM are quite variable.

    Overall progression risk was 10%/year for the first five years, 3%/yr for the next five years, then 1%/year for the next ten years. Cumulative risk for progression was 73% at 15 years.

    • Provides prognostic information for patients.
    • Suggests patients who may need closer follow up.
    • Allows for stratification of patients on clinical trials potentially evaluating newer, targeted myeloma therapies.
    • Does not require FISH studies, cytogenetic, or MRI bone studies, which may add further discrimination but are not widely available; hence, generalizability is preserved in settings with limited availability of these studies.
    ≥10%
    <10%
    ≥3
    <3

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Robert A. Kyle

    About the Creator

    Robert A. Kyle, MD, is a professor of medicine and laboratory medicine and pathology at the Mayo Clinic in Rochester, Minnesota. He is widely regarded as a pioneer in multiple myeloma research, having published numerous critical papers on topics including monoclonal gammopathies, multiple myeloma, amyloidosis, and macroglobulinemia.

    To view Dr. Robert A. Kyle's publications, visit PubMed

    Are you Dr. Robert A. Kyle? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
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    About the Creator
    Dr. Robert A. Kyle
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