What are the symptoms of SMM, and how long can you have it?

[Music] what are the symptoms of smoldering at multiple myeloma smoldering myeloma should have no active symptoms of myeloma so we don't have the hypercalcemia anemia the lytic lesions the renal failure and we don't have other markers to 60% plasma cells having said that patients do have symptoms we just don't capture it because we don't have database of all of the other symptoms I see patients with neuropathy I see patients with fatigue I see patients having rheumatological like things there are symptoms related to it we just don't capture it correctly and it's very hard to capture fatigue and other things that are not very objective how likely are you to progress to active myeloma in general the rate of progression of smoldering myeloma is 10% 3-year but that doesn't mean anything there is a chance every year that you have myeloma and a chance that you would never have myeloma 90% chances you will not have myeloma and within the first five years that's the highest rate of progression of 10% per year 50% in five years however people confuse those curves later on and say well if I've already had five years then I'm actually fine I'm not going to develop myeloma that's not true what we know from that large cohort of data is because it was so heterogeneous the ones who looked more like myeloma the high-risk ones the ultra high risk ones all developed myeloma very fast within those first five years so the ones left over are the ones who have a better prognostic markers are the ones who likely are the M dust-like and they can still develop myeloma but the risk of progression is much lower because all of the ones who are going to have bad disease already had the disease happening if smoldering myeloma can behave so differently between patients should we still call it smoldering myeloma I think in general smoldering myeloma needs to be redefined but there may be an entity still that's called smoldering myeloma they're not M Gus they're not the high-risk group there is that intermediate group and it just needs to be defined correctly with the understanding of the biology underlying these patients but I'm not saying that we will remove smoldering myeloma there is an intermediate between M Gus and myeloma we just need to read correctly we encourage you to fill out your full health profile in health tree to help us determine if there are other factors that may influence progression from smoldering myeloma to active myeloma [Music]