Monitoring
Patients smouldering multiple myeloma (SMM) do not require therapy, but do need to be monitored closely. Disease progression in patients with SMM may take several months or years; therefore, these patients should initially be observed at 3- to 6-month intervals.[41] Randomised trials report that early intervention with single-agent lenalidomide or lenalidomide plus dexamethasone can significantly delay progression to active MM in patients with intermediate- or high-risk SMM, compared with observation.[238][239][240]
Patients with active MM require close monitoring for relapse or disease progression following treatment. Those in complete remission after first-line therapy or stem cell transplantation should be monitored for any rise of the M-protein at 3- to 6-month intervals. Imaging should be performed annually or as clinically indicated, ideally with the same technique used at diagnosis.[45]
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