Smoldering myeloma differs from active multiple myeloma in that it:
- A Has 10–60% bone marrow plasma cells and/or ≥3 g/dL M-protein, but lacks CRAB criteria and myeloma-defining biomarkers ✓
- B Has <10% plasma cells in bone marrow and no M-protein
- C Is characterized by IgM paraprotein exclusively
- D Always progresses to active myeloma within 6 months
Correct answer: A. Has 10–60% bone marrow plasma cells and/or ≥3 g/dL M-protein, but lacks CRAB criteria and myeloma-defining biomarkers
Explanation
Smoldering (asymptomatic) myeloma is defined by ≥10% clonal bone marrow plasma cells and/or serum M-protein ≥3 g/dL, but the absence of end-organ damage (hypercalcemia, renal failure, anemia, bone lesions — CRAB) and the absence of myeloma-defining biomarkers such as ≥60% marrow plasma cells, serum FLC ratio ≥100, or >1 focal lesion on MRI. IgM paraproteins belong to Waldenström macroglobulinemia. Progression risk is approximately 10% per year for the first 5 years, not universal at 6 months.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.