Is there a clear definition for standard-risk smoldering myeloma?

[Music] is there a clear definition for standard risk smothering myeloma again will redefining smoldering myeloma so there is nothing that's correct about what is intermediate or low-risk smoldering myeloma if you have a 17 P deletion and your M spike and light chain are increasing every six months but you are classified as low-risk smoldering myeloma when you are diagnosed you're not low-risk smoldering myeloma it needs to be defined as a continuum because a patient is not a one-time event and there is that question of let's make sure we're redefining it every time we see you it is probably not really accurate the way we define and talk about smaller in myeloma it is for sure not a clean entity I would guess that many of the patients that are called smaller in myeloma actually are monoclonal gammopathy and I would say the patients who develop the disease very shortly after the diagnosis of smoldering myeloma they probably have multiple myeloma in the first place but it was just not identified and they for sure probably should be treated so the dilemma is that we need to improve the tools that we use to identify patients who are on the way to develop myeloma in patients who really don't have multiple myeloma or smoldering myeloma they should really retool they have the monoclonal gammopathy there may still be a group in the middle that is small where it's unclear what the right management is in general smaller myeloma should only be treated inside of a clinical trial if you have joined a smoldering myeloma clinical trial please add your treatments and health tree so we can collectively see how well early intervention is working for these patients you [Music]