IMWG risk model for smoldering multiple myeloma (SMM)

This risk score accounts for the entire range of the variables in the 2/20/20 model, which can be used to provide a more individualized 2-year risk of progression for every SMM patient.


Based on the univariate and multivariate analysis previously conducted, the three risk factors (serum M-protein, involved to uninvolved sFLC ratio, and BMPC infiltration) together with the cytogenetic abnormalities were included in a logistic regression model for creating a scoring tool to provide a more individualized assessment of risk. This approach allowed us to utilize the variables along the entire range of values instead of using single cut points. Six hundred and eighty-nine patients were included. Patients with total risk score between 0 and 4 had a 2-year progression risk of 3.8% (reference group). The risk was 26% (HR: 7.56, 95% CI: 3.77–15.2) for patients with a total score between 5 and 8, and for those with a score between 9 and 12, the risk of progression at 2 years was 51% (HR: 17.3, 95% CI: 8.63–34.8). When the score was >12, the 2-year progression risk was 73% (HR: 31.9, 95% CI: 15.4–66.3).


Mateos, MV., Kumar, S., Dimopoulos, M.A. et al.

Blood Cancer J. 10, 102 (2020).

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1. The involved to uninvolved free light chain ratio?

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