Smoldering Myeloma Risk Calculator

Smoldering myeloma risk factors include a high M-protein level (>2 grams per deciliter), an elevated percentage of plasma cells in the bone marrow (>20%), specific genetic abnormalities, presence of proteinuria, abnormal free light chain ratio, bone lesions or fractures, anemia, and impaired kidney function. The 20-2-20 rule is also used to assess risk based on combinations of these factors.

Risk Factor	Definition/Description
M-Protein Level	– High M-protein level in the blood (>2 grams per deciliter) increases risk.
Plasma Cell Percentage in Bone Marrow	– A higher percentage of plasma cells in the bone marrow (>20%) increases risk.
Genetic Abnormalities	– Specific genetic abnormalities, such as cytogenetic abnormalities, may indicate higher risk.
20-2-20 Rule	– Presence of any one of the following criteria increases risk: – >20% plasma cells in bone marrow. – M-protein level >2 g/dL. – >20% plasma cells in bone marrow + M-protein level >20 g/dL.
Proteinuria	– The presence of protein in the urine (proteinuria) may be associated with higher risk.
Light Chain Ratio	– An abnormal free light chain ratio can be a risk factor.
Bone Lesions	– The presence of bone lesions or fractures may increase risk.
Anemia	– Anemia (low red blood cell count) can be indicative of higher risk.
Kidney Function	– Impaired kidney function due to myeloma can be associated with higher risk.

FAQs

What is considered high risk smoldering myeloma? High-risk smoldering myeloma is typically defined by specific criteria, including higher levels of certain proteins in the blood (such as M-protein or monoclonal protein), a higher percentage of plasma cells in the bone marrow, and specific genetic abnormalities. It’s estimated that about 15-20% of smoldering myeloma cases are classified as high risk.

What is the 20 2 20 rule for smoldering myeloma? The 20-2-20 rule is used to determine the risk of progression in smoldering myeloma. It refers to the presence of any one of the following criteria:

1. More than 20% plasma cells in the bone marrow.
2. An M-protein level (monoclonal protein) of more than 2 grams per deciliter (g/dL) in the blood.
3. More than 20% plasma cells in the bone marrow along with an M-protein level of more than 20 g/dL in the blood. Meeting any of these criteria suggests a higher risk of progression to active multiple myeloma.

What is the progression rate of Smouldering myeloma? The progression rate of smoldering myeloma can vary widely. On average, about 10% of people with smoldering myeloma progress to active multiple myeloma each year. However, this rate can be influenced by individual patient characteristics, including risk factors.

Does smoldering multiple myeloma always progress? No, smoldering multiple myeloma does not always progress to active myeloma. Some cases of smoldering myeloma remain stable for many years or even indefinitely without progressing to symptomatic disease.

Should you treat smoldering multiple myeloma? Treatment for smoldering myeloma is not always necessary, especially for low-risk cases. The decision to treat is based on factors such as risk stratification, the presence of symptoms, and the potential benefits and risks of treatment. High-risk smoldering myeloma cases may be considered for early intervention to prevent progression.

What is the life expectancy of someone with smoldering multiple myeloma? The life expectancy of someone with smoldering multiple myeloma can vary widely depending on factors such as risk profile, overall health, and access to treatment. On average, people with smoldering myeloma have a better prognosis than those with active multiple myeloma. Some individuals with smoldering myeloma may never progress to active disease, while others may eventually develop symptomatic myeloma.

How do you slow the progression of smoldering myeloma? Slowing the progression of smoldering myeloma may involve close monitoring by a healthcare provider, lifestyle modifications, and, in some cases, medical intervention. Treatment options, if considered, may include clinical trials, chemotherapy, immunomodulatory drugs, or targeted therapies. The approach varies based on individual risk factors and medical recommendations.

Do you lose weight with smoldering myeloma? Weight loss is not typically a prominent symptom of smoldering myeloma. Weight loss is more commonly associated with active multiple myeloma, where it can result from factors such as reduced appetite, bone pain, and metabolic changes.

How long does it take for smoldering myeloma to progress? The time it takes for smoldering myeloma to progress to active multiple myeloma varies widely among individuals. Some people may remain stable for years or decades, while others may progress more quickly. On average, about 10% of smoldering myeloma cases progress to active myeloma each year.

How do you know if myeloma is active? Active myeloma is typically characterized by the presence of certain symptoms and laboratory findings. Common symptoms include bone pain, fatigue, anemia, kidney problems, recurrent infections, and elevated levels of M-protein in the blood or urine. A healthcare provider may use blood tests, bone marrow biopsies, imaging studies, and clinical evaluations to diagnose and monitor active myeloma.

Does myeloma make you tired? Yes, multiple myeloma can cause fatigue. Fatigue is a common symptom in people with active myeloma, often due to anemia (low red blood cell count) and the overall impact of the disease on the body.

What does smoldering myeloma feel like? Smoldering myeloma is often asymptomatic, meaning it doesn’t cause noticeable symptoms in many cases. When symptoms are present, they may include vague bone pain, recurrent infections, or mild fatigue. However, these symptoms are not specific to smoldering myeloma and can be caused by other conditions as well.

How many times can you go into remission with myeloma? Multiple myeloma is a chronic condition, and remissions can occur multiple times with appropriate treatment. Some individuals may experience multiple remissions and relapses over the course of their disease. The goal of treatment is often to achieve and maintain remission, even if it is not always a permanent state.

Does smoldering myeloma cause weight gain? Weight gain is not typically associated with smoldering myeloma. Weight changes are more likely to occur due to other factors, such as medication side effects or lifestyle changes.

What is the standard of care for smoldering multiple myeloma? The standard of care for smoldering multiple myeloma can vary based on individual risk factors and evolving medical guidelines. In some cases, close monitoring without immediate treatment may be recommended, while in high-risk cases, clinical trials or early intervention with medication may be considered. Consultation with a hematologist-oncologist is essential to determine the most appropriate approach.

Does smoldering myeloma qualify for disability? Whether smoldering myeloma qualifies for disability benefits depends on individual circumstances, including the severity of symptoms and their impact on a person’s ability to work. Eligibility for disability benefits is determined by the specific criteria of the disability program in your country or region.

What is an alternative treatment for smoldering myeloma? Alternative treatments for smoldering myeloma may include participation in clinical trials, complementary therapies (such as acupuncture or dietary supplements), and lifestyle modifications. However, the choice of treatment or approach should be discussed with a healthcare provider and based on individual circumstances.

Can you live 30 years with myeloma? Living with multiple myeloma for 30 years is unusual, but it is not impossible. Advances in treatment options, including novel therapies and stem cell transplantation, have improved the outlook for some patients. However, the prognosis can vary significantly based on individual factors, disease stage, and response to treatment.

Is multiple myeloma the same as smoldering multiple myeloma? Multiple myeloma and smoldering myeloma are related conditions, but they are not the same. Multiple myeloma is an active, symptomatic cancer of plasma cells in the bone marrow, while smoldering myeloma is an asymptomatic precursor condition with a lower tumor burden.

What is the most frequent cause of death in a patient with multiple myeloma? The most frequent cause of death in patients with multiple myeloma is often related to complications of the disease, such as infections, kidney failure, or severe bone damage. In some cases, treatment-related complications may also contribute to mortality.

How do you know when multiple myeloma is in remission? Remission in multiple myeloma is typically assessed through a combination of clinical evaluations, blood tests (including M-protein levels), and bone marrow biopsies. A healthcare provider will monitor these factors to determine if the disease is under control and if the patient meets the criteria for remission.

Does smoldering myeloma affect the kidneys? Smoldering myeloma itself does not usually cause significant kidney problems. However, if smoldering myeloma progresses to active multiple myeloma, it can lead to kidney damage as a result of excessive protein production and the deposition of abnormal proteins in the kidneys.

Can you travel with multiple myeloma? Traveling with multiple myeloma is possible, but it may require careful planning and consideration of your health status. Consult with your healthcare team before making travel plans, especially if you need ongoing treatment or have specific medical needs.

What diet for Smouldering myeloma? There is no specific diet for smoldering myeloma, but maintaining a balanced and healthy diet is generally advisable. A diet rich in fruits, vegetables, lean proteins, and whole grains can help support overall health. However, individual dietary recommendations may vary based on specific medical needs and any treatment-related dietary restrictions.

What should you avoid if you have myeloma? If you have myeloma, you should generally avoid excessive alcohol consumption, tobacco use, and exposure to infections. Additionally, you should follow any dietary recommendations provided by your healthcare team and take precautions to prevent bone injuries, as myeloma can weaken bones.

Does multiple myeloma affect the bowels? Multiple myeloma can indirectly affect the bowels if it leads to complications such as constipation, diarrhea, or malabsorption of nutrients. Additionally, some medications used to treat myeloma may have gastrointestinal side effects.

Is MGUS the same as smouldering myeloma? MGUS (Monoclonal Gammopathy of Undetermined Significance) is a related condition to smoldering myeloma but has distinct differences. MGUS involves the presence of an abnormal protein (M-protein) in the blood, but it lacks the higher levels of plasma cells in the bone marrow seen in smoldering myeloma. MGUS has a lower risk of progression to active multiple myeloma compared to smoldering myeloma.

Do doctors treat smoldering myeloma? The treatment of smoldering myeloma depends on individual risk factors and medical recommendations. In some cases, especially for low-risk smoldering myeloma, doctors may opt for close monitoring without immediate treatment. High-risk cases or clinical trial participation may involve medical intervention.

How do you know what stage of myeloma you have? The stage of myeloma is determined using a system called the International Staging System (ISS), which takes into account factors such as the level of certain proteins (beta-2 microglobulin and albumin) in the blood. Staging helps guide treatment decisions and predict prognosis.

Can smoldering multiple myeloma cause osteoporosis? Smoldering multiple myeloma itself does not directly cause osteoporosis, but it can contribute to bone weakening and fractures over time. This is because myeloma cells can disrupt normal bone function and structure, leading to bone loss and increased risk of fractures.

Can you claim PIP for myeloma? Whether you can claim Personal Independence Payment (PIP) or similar disability benefits for myeloma depends on your individual circumstances, the severity of your symptoms, and the eligibility criteria established by your country’s disability support program.

Is myeloma classed as a terminal illness? Multiple myeloma can be a serious and life-threatening condition, but it is not always classified as a terminal illness. The prognosis varies widely, and some individuals respond well to treatment and can achieve remission or long-term control of the disease. Others may have a more challenging prognosis.

Can you have myeloma for years without knowing? Yes, it is possible to have myeloma for years without knowing, especially if the disease is in the smoldering myeloma stage or if symptoms are mild and not recognized as related to myeloma. Regular check-ups and medical evaluations are important for early detection.

What organ does myeloma affect? Myeloma primarily affects the bone marrow and bone tissue. It can also have systemic effects on other organs and systems, including the kidneys, immune system, and blood.

Can myeloma be caused by stress? There is no direct evidence to suggest that stress causes myeloma. Myeloma is a complex cancer with multiple factors contributing to its development, including genetic and environmental factors. Stress may have an indirect impact on overall health and well-being but is not considered a direct cause of myeloma.

Does myeloma cause weak legs? Weakness in the legs can occur in individuals with myeloma, particularly if the disease has led to bone damage or compression fractures in the spine. These fractures can affect nerve function and lead to muscle weakness in the legs.

Where does myeloma pain start? Myeloma-related pain often starts in the bones, especially in areas with bone damage or fractures. Common sites of pain include the spine, ribs, pelvis, and long bones of the arms and legs.

What are the unusual symptoms of myeloma? Unusual symptoms of myeloma can include neurological symptoms (due to spinal cord compression), skin changes, unexplained bruising, and unusual bleeding. However, these symptoms are less common and typically occur in more advanced stages of the disease.

What age do myeloma symptoms start? Myeloma symptoms can start at any age, but the disease is more commonly diagnosed in individuals over the age of 65. However, it can affect younger people as well.

What is the first relapse of myeloma? The first relapse in myeloma refers to the recurrence of the disease after an initial period of remission. It means that myeloma has become active again, and treatment may need to be adjusted or restarted to control the cancer.

What is the second line of treatment for myeloma in the UK? The second line of treatment for myeloma in the UK may involve different chemotherapy regimens, immunomodulatory drugs, proteasome inhibitors, targeted therapies, or stem cell transplantation, depending on the individual’s response to initial treatment and specific circumstances.

Has anyone been cured of myeloma? While myeloma is generally considered a chronic condition, some individuals achieve long-term remission or are effectively cured, especially if they receive intensive treatments such as stem cell transplantation and newer targeted therapies. However, a complete and permanent cure for myeloma remains challenging.

Is Smouldering myeloma serious? Smoldering myeloma is a serious condition because it can progress to active multiple myeloma, which can be life-threatening. The seriousness of smoldering myeloma depends on individual risk factors and the potential for progression.

What does myeloma fatigue feel like? Myeloma-related fatigue can manifest as a deep and persistent feeling of tiredness, weakness, and lack of energy. It can be debilitating and may not improve with rest.

Is coffee good for multiple myeloma? Coffee consumption is not specifically recommended as a treatment for multiple myeloma. However, some studies have suggested that moderate coffee consumption may be associated with a reduced risk of developing certain cancers, including myeloma. It’s important to maintain a balanced and healthy diet overall.

What are the levels for Smouldering myeloma? The “levels” for smoldering myeloma usually refer to specific diagnostic criteria used to determine its risk status. These criteria include percentages of plasma cells in the bone marrow and levels of M-protein in the blood.

How fast does smoldering myeloma progress? The rate of progression of smoldering myeloma can vary widely among individuals. On average, about 10% of cases progress to active myeloma each year. However, some individuals may progress more rapidly, while others may remain stable for many years or even indefinitely.

Can I get a blue badge with myeloma? Whether you can get a Blue Badge (disabled parking permit) with myeloma depends on the specific regulations and criteria established by your country or region. Eligibility for a Blue Badge is typically determined based on mobility and disability-related needs.

How do you slow the progression of smoldering myeloma? Slowing the progression of smoldering myeloma may involve close monitoring by healthcare providers, lifestyle modifications (such as quitting smoking and maintaining a healthy diet), and, in some cases, medical intervention based on individual risk factors.

What is the difference between myeloma and Smouldering myeloma? The main difference between myeloma and smoldering myeloma is that myeloma, also known as multiple myeloma, is an active cancer characterized by the presence of symptoms, while smoldering myeloma is a precursor condition without symptoms. Smoldering myeloma has a lower tumor burden and a lower risk of progression to active myeloma.

What vitamins help multiple myeloma? There is no specific vitamin that can treat or cure multiple myeloma. However, maintaining overall good nutrition is important for managing the condition. Your healthcare team may recommend supplements or dietary adjustments based on individual nutritional needs.

Where does myeloma spread to first? Myeloma primarily affects the bone marrow and bone tissue. It often spreads to multiple bones throughout the body, with a preference for the spine, ribs, pelvis, and long bones of the arms and legs.

Can you lead a normal life with myeloma? Many individuals with myeloma can lead relatively normal lives, especially with appropriate treatment and support. However, the impact of the disease on daily life can vary widely depending on factors such as the stage of the disease, treatment response, and overall health.

Does alcohol cause multiple myeloma? Excessive alcohol consumption is considered a risk factor for multiple myeloma, but it is not the sole cause of the disease. Myeloma is a complex condition with multiple contributing factors, including genetic and environmental influences.

Is multiple myeloma like leukemia? Multiple myeloma and leukemia are both cancers of the blood and bone marrow, but they are distinct diseases with different characteristics. Multiple myeloma specifically involves plasma cells in the bone marrow and the production of abnormal proteins, while leukemia affects various types of blood cells, such as white blood cells, red blood cells, and platelets.

What are the three types of multiple myeloma? There are several subtypes of multiple myeloma, but they are generally categorized into three main types based on the type of abnormal immunoglobulin (M-protein) produced:

1. IgG Multiple Myeloma (most common)
2. IgA Multiple Myeloma
3. Light Chain Multiple Myeloma (also known as Bence Jones myeloma)

How do people with multiple myeloma end up dying? People with multiple myeloma can die from complications of the disease, such as infections, kidney failure, severe bone damage, or complications related to treatment. The exact cause of death can vary widely depending on individual circumstances and the progression of the disease.

When does myeloma become terminal? Myeloma may be considered terminal when it reaches an advanced stage and no longer responds to available treatments, or when it causes severe complications that cannot be managed effectively. However, the progression and prognosis of myeloma are highly variable, and some individuals achieve long-term remission or stable disease.

What is very good partial remission in multiple myeloma? Very Good Partial Remission (VGPR) is a term used to describe a deep and favorable response to myeloma treatment. It means that there is a significant reduction in the levels of abnormal proteins (M-proteins) in the blood and urine, as well as a decrease in cancer-related symptoms. VGPR indicates a positive treatment outcome.

What makes smoldering myeloma high risk? Smoldering myeloma is considered high risk when specific criteria are met, such as higher levels of M-protein in the blood, a higher percentage of plasma cells in the bone marrow, or the presence of certain genetic abnormalities. High-risk smoldering myeloma has a greater likelihood of progressing to active multiple myeloma.

What organ is most affected by multiple myeloma? Multiple myeloma primarily affects the bone marrow and bones. However, it can have systemic effects on other organs and systems, with the kidneys being one of the most commonly affected organs due to the deposition of abnormal proteins.

Does a myeloma diagnosis qualify for disability? Whether a myeloma diagnosis qualifies for disability benefits depends on individual circumstances, the severity of symptoms, and the eligibility criteria established by your country or region’s disability support program.

Is walking good for myeloma? Regular physical activity, including walking, can be beneficial for individuals with myeloma, as it can help maintain overall fitness, improve mood, and enhance quality of life. However, the level of activity should be tailored to individual capabilities and discussed with a healthcare provider.

Does Smouldering myeloma make you tired? Smoldering myeloma itself typically does not cause significant fatigue. Fatigue is more commonly associated with active myeloma, where it can result from factors such as anemia, disease-related stress, or treatment side effects.

What diet for Smouldering myeloma? There is no specific diet recommended exclusively for smoldering myeloma. A balanced and healthy diet that includes a variety of fruits, vegetables, lean proteins, whole grains, and adequate hydration is generally advisable. Dietary recommendations may also vary based on individual nutritional needs and any treatment-related dietary restrictions.

What is the quality of life for a person with myeloma? The quality of life for a person with myeloma can vary widely depending on factors such as the stage of the disease, response to treatment, overall health, and access to supportive care. Many individuals with myeloma can achieve a good quality of life with appropriate medical management and support.

What stomach problems do you have with myeloma? Myeloma itself does not typically cause direct stomach problems. However, some individuals with myeloma may experience gastrointestinal symptoms related to medications, treatment side effects, or complications of the disease, such as constipation, diarrhea, or nausea.

Why do you get belly pain with multiple myeloma? Abdominal or belly pain in multiple myeloma can occur if the disease has caused compression fractures or other bone-related issues in the spine or ribs. It can also be due to organ involvement or gastrointestinal issues.

How does myeloma affect the stomach? Myeloma can indirectly affect the stomach through various mechanisms, such as treatment-related gastrointestinal side effects, bone pain or fractures affecting the spine, or complications from other organs, like the kidneys.

How long does it take for MGUS to turn into multiple myeloma? The progression of MGUS (Monoclonal Gammopathy of Undetermined Significance) to multiple myeloma is relatively slow and variable. On average, the risk of progression from MGUS to multiple myeloma is estimated to be about 1% per year, meaning that it may take many years or even decades for some individuals to develop active myeloma.

What is high risk smouldering myeloma? High-risk smoldering myeloma typically refers to cases of smoldering myeloma with certain characteristics associated with a higher likelihood of progressing to active multiple myeloma. These characteristics may include higher levels of M-protein, a greater percentage of plasma cells in the bone marrow, or specific genetic abnormalities.

What is considered high risk MGUS? High-risk MGUS is characterized by certain factors that increase the risk of progression to multiple myeloma. These factors may include a high level of M-protein in the blood (typically over 1.5 grams per deciliter), an abnormal free light chain ratio, or the presence of specific genetic abnormalities.

Can you claim PIP for myeloma? Whether you can claim Personal Independence Payment (PIP) or similar disability benefits for myeloma depends on individual circumstances, the severity of your symptoms, and the eligibility criteria established by your country or region’s disability support program.

What is the latest treatment for smouldering myeloma? Treatment approaches for smoldering myeloma continue to evolve, and the latest treatments may include enrollment in clinical trials to explore novel therapies and strategies for delaying progression to active myeloma. Treatment decisions are typically individualized based on specific risk factors and medical recommendations.

What is an alternative treatment for smoldering myeloma? Alternative treatments for smoldering myeloma may include participation in clinical trials, complementary therapies (such as acupuncture or dietary supplements), and lifestyle modifications. The choice of treatment or approach should be discussed with a healthcare provider and tailored to individual needs and circumstances.