Smoldering multiple myeloma (SMM) is an asymptomatic precursor to active multiple myeloma (MM). The aim of this study was to report clinical characteristics and outcomes of patients with SMM stratified based on their risk of progression to MM using the Mayo 20/2/20 criteria. Data were leveraged from the Czech Myeloma Group Registry of Monoclonal Gammopathies (RMG). Key outcomes included progression-free survival from SMM diagnosis to active MM diagnosis or death (PFS), progression-free survival from SMM diagnosis to progression on first line (1 L) MM treatment or death (PFS2), and overall survival (OS). Of 498 patients, 174 (34.9%) were classified as high risk and 324 (65.1%) as non-high risk. Median follow-up was approximately 65 months. During follow-up, more patients in the high-risk vs non-high-risk group received 1 L MM treatment (76.4% vs 46.6%, p < 0.001). PFS, PFS2, and OS were significantly shorter in high-risk vs non-high-risk patients (13.2 vs 56.6 months, p < 0.001; 49.9 vs 84.9 months, p < 0.001; 93.2 vs 131.1 months, p = 0.012, respectively). The results of this study add to the growing body of evidence that patients with high-risk vs non-high-risk SMM have significantly worse outcomes, including OS.

Charles University and General Hospital Prague Prague Czech Republic

Charles University Hospital and Faculty of Medicine Hradec Kralove Hradec Kralove Czech Republic

Hospital Ceske Budejovice Ceske Budejovice Czech Republic

Hospital Novy Jicin Novy Jicin Czech Republic

Hospital Pelhrimov Pelhrimov Czech Republic

Institute of Biostatistics and Analyses Ltd Brno Czech Republic

Janssen Cilag GmbH Neuss Germany

Janssen Cilag Madrid Spain

Janssen Global Services Budapest Hungary

Janssen Global Services Raritan NJ USA

Janssen Global Services Titusville NJ USA

KZ Masaryk Hospital in Usti nad Labem Usti nad Labem Czech Republic

Liberec Regional Hospital Liberec Czech Republic

Motol University Hospital Prague Czech Republic

Regional Hospital Mlada Boleslav Mlada Boleslav Czech Republic

Silesian Hospital in Opava Opava Czech Republic

University Hospital Brno Brno Czech Republic

University Hospital Kralovske Vinohrady Prague Czech Republic

University Hospital Olomouc Olomouc Czech Republic

University Hospital Ostrava and Faculty of Medicine Ostrava Czech Republic

University Hospital Pilsen Pilsen Czech Republic

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