HealthTree Research At The COMy Conference: How Early Are Myeloma Patients Diagnosed?

HealthTree Research presented valuable insights from real-world results powered by patients who advocate for accelerating lifesaving research. At the Controversies in Multiple Myeloma conferences (COMy), HealthTree’s database analysis showed real-world results from 2006–2024 on early myeloma diagnosis. 

This analysis shed light on the time it took for patients to be diagnosed, and the parameters used: SLiM criteria, CRAB criteria, and both SLiM and CRAB. 

Learn how the inclusion of new biomarkers for earlier diagnosis of myeloma has affected real-world clinical practices, and why some patients still face delays in diagnosis.

Understanding the Diagnostic Shift

In 2014, the International Myeloma Working Group (IMWG) expanded how myeloma could be diagnosed. Before this change, patients were diagnosed only after experiencing symptoms of organ damage, often identified using the CRAB features: Calcium elevation, Renal failure, Anemia, and Bone lesions.

The revision introduced three additional early warning signs known as SLiM biomarkers:

• Sixty percent or more plasma cells in the bone marrow
• Light chain ratio of 100 or more in blood tests
• More than one area of bone damage found by MRI

These updates were meant to catch myeloma sooner. The purpose is to begin treatment earlier and preserve quality of life. 

Is Myeloma Being Diagnosed Earlier?

Despite the intended benefits of earlier detection, the HealthTree Research team wanted to find out whether these changes translated into faster diagnoses in real-world settings. They analyzed data from 584 patients diagnosed with myeloma between 2006 and 2024 using the HealthTree Cure Hub Registry.

Researchers tracked when patients first showed either SLiM or CRAB features and how much time passed before they were officially diagnosed. This time period is called the diagnostic interval.

Patients were grouped into three categories based on how they first presented:

• 26.7% SLiM-only: showing one or more of the newer biomarkers, but no CRAB symptoms
• 33.6% CRAB-only: showing traditional signs of end-organ damage without SLiM features
• 39.7% SLiM+CRAB: showing a combination of both types

Key Findings: A Mixed Picture on Timing

SLiM+CRAB cases increased over time, from 23.5% in 2014 to 44.4% in 2024, suggesting greater awareness of early signs in clinical practice.

However, after the 2014 guideline update, the median diagnostic interval was 25 days before 2014 and increased slightly to 31 days after 2014. This difference was not statistically significant.

This means that, overall, diagnosis did not happen more quickly after introducing SLiM criteria. For patients, this suggests that earlier diagnosis may still depend heavily on how symptoms present and whether providers recognize early warning signs.

Why Some Patients Still Wait Longer

Patients who had only SLiM features without organ damage experienced longer delays before diagnosis. In comparison, patients with CRAB-only or SLiM+CRAB were diagnosed significantly faster:

• CRAB-only patients were diagnosed 229.5 days sooner 
• SLiM+CRAB patients were diagnosed 157 days sooner

These findings underscore how myeloma can still be missed when symptoms are subtle or don’t fit traditional patterns. For patients, this is important because earlier diagnosis means earlier access to treatment, which may help slow disease progression.

There is Progress, But Gaps Remain

While more people are being diagnosed with myeloma based on the newer SLiM criteria, this has not yet translated into faster diagnosis. Patients who don’t show obvious symptoms of organ damage may still face delays.

This highlights the importance of regular follow-ups and thorough evaluations. Especially for individuals with known precursor conditions like MGUS or smoldering myeloma. It also reflects a need for ongoing education among healthcare providers to recognize early, SLiM-only signs.

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