Frequency of Smoldering Multiple Myeloma in Patients with Abnormal Bone Marrow Plasma Cells Infiltrates

BACKGROUND: Smoldering multiple myeloma is believed to be a rare, asymptomatic plasma cell disorder, representing an intermediate bridge between monoclonal gammopathy of undetermined significance and multiple myeloma. Smoldering multiple myeloma attained focus due to high risk of progression, major advances in the diagnosis, prognosis, and management. It is assumed that greater significance on the basis of recent trials with early therapy can be potentially beneficial to patients. OBJECTIVE: To determine frequency of smoldering multiple myeloma in patients, presenting with plasma cell dyscrasias in the study area.  MATERIALS & METHODS: All cases having abnormal bone marrow plasma cells infiltrates with relevant investigations were divided into three groups. Group (1) Plasma cell infiltrates   of 10% and without any complications. Group (3) Plasma cell infiltrates of > 10% and with complications hypercalcemia, renal failure, anemia, lytic bone lesions (CRAB). Cases with reactive plasma cells having no predominant multi nucleurity and no cytoplasmic flaming/skirting were excluded from the study. Data was analyzed on SPSS (Version 17.0). RESULTS:  A total of 26 cases of abnormal bone marrow plasma cells infiltrates were studied in both sexes with male and female ratio of (3:1) out of which 3 cases (11.5%) were found to have smoldering multiple myeloma.  All of the three cases were males. The age was ranging from 36 to 80 years. Twenty two (84.7%) cases were having multiple myeloma and one (3.8%) were having monoclonal gammopathy of undetermined significance. CONCLUSION: High risk smoldering multiple myeloma may be given with trials of therapy, before it develops into Myeloma complication/myeloma defining entity (MDE). However low risk Smoldering Multiple Myeloma needs close observation/follow ups