Smoldering multiple myeloma (SMM)

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Stages

Smoldering multiple myeloma does not use numbered stages such as stage 1, stage 2 or stage 3. Instead, it is classified by the risk of progression.

If a myeloma-defining event occurs, the diagnosis changes to active multiple myeloma. The care team then stages the active myeloma and creates a treatment plan.

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Diagnosis & treatmentSurvival rates
Aug. 15, 2026

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  1. Multiple myeloma. National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/pdf/myeloma.pdf. Accessed August 4, 2026.
  2. Kumar SK, et al. Multiple myeloma, version 5.2026, NCCN Clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network. 2026; doi:10.6004/jnccn.2026.0001.
  3. Zanwar S, et al. Diagnosis, risk stratification and management of smouldering multiple myeloma. Nature Reviews Clinical Oncology. 2026; doi:10.1038/s41571-026-01119-0.
  4. Mateos MV, et al. International Myeloma Working Group risk stratification model for smoldering multiple myeloma (SMM). Blood Cancer Journal. 2020; doi:10.1038/s41408-020-00366-3.
  5. Chabrun F, et al. Enhanced dynamic risk stratification of smoldering multiple myeloma. Nature Medicine. 2026; doi:10.1038/s41591-026-04304-x.
  6. Ludwig H, et al. Temporal trends in progression risk in smoldering myeloma: A systematic review. eClinicalMedicine. 2026; doi:10.1016/j.eclinm.2025.103750.
  7. Sandecka V, et al. Clinical characteristics and outcomes in risk-stratified patients with smoldering multiple myeloma: data from the Czech Republic Registry of Monoclonal Gammopathies. Blood Cancer Journal. 2023; doi:10.1038/s41408-023-00906-7.
  8. Ntanasis-Stathopoulos I, et al. Observation or treatment for smoldering multiple myeloma? A systematic review and meta-analysis of randomized controlled studies. Blood Cancer Journal. 2025; doi:10.1038/s41408-025-01312-x.
  9. Dimopoulos MA, et al. Daratumumab or active monitoring for high-risk smoldering multiple myeloma. New England Journal of Medicine. 2025; doi:10.1056/NEJMoa2409029. Erratum published 2026.
  10. U.S. Food and Drug Administration. FDA approves daratumumab and hyaluronidase-fihj for high-risk smoldering multiple myeloma. Accessed August 4, 2026.

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Smoldering multiple myeloma (SMM)