Great question — and it sounds like you mean smoldering myeloma (an easy name to mix up!). This is an early, inactive phase where myeloma is present but not yet causing symptoms or organ damage.
Traditionally, the approach has been watchful waiting — monitoring closely without starting treatment. The upside is avoiding Show Full Answer
Great question — and it sounds like you mean smoldering myeloma (an easy name to mix up!). This is an early, inactive phase where myeloma is present but not yet causing symptoms or organ damage.
Traditionally, the approach has been watchful waiting — monitoring closely without starting treatment. The upside is avoiding treatment side effects for as long as possible. However, thinking is shifting, especially for high-risk smoldering myeloma. Here's what's new and notable:
- In 2025, the FDA approved daratumumab and hyaluronidase-fihj as the first treatment specifically for high-risk smoldering myeloma
- Earlier treatment in high-risk cases may delay progression to active myeloma
- Drugs like lenalidomide and low-dose dexamethasone have shown promise in clinical trials for reducing the chance of progression
- Some people with smoldering myeloma take bisphosphonates (like Zometa or Xgeva) to protect bone strength
This doesn't mean everyone with smoldering myeloma should rush into treatment. Decisions are becoming increasingly personalized, so talking with your oncologist about your specific risk level is really important.
2 days ago