Ntanasis-Stathopoulos Ioannis, Koutoulidis Vassilis, Malandrakis Panagiotis, Fotiou Despina, Spiliopoulou Vasiliki, Filippatos Charalampos, Migkou Magdalini, Kanellias Nikolaos, Theodorakakou Foteini, Eleutherakis-Papaiakovou Evangelos, Kastritis Efstathios, Terpos Evangelos, Dimopoulos Meletios-Athanasios, Moulopoulos Lia-Angela, Gavriatopoulou Maria
Department of Clinical Therapeutics, School of Medicine, General Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece.
1st Department of Radiology, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece.
J Clin Med. 2025 Mar 25;14(7):2224. doi: 10.3390/jcm14072224.
Smoldering multiple myeloma (SMM) represents an intermediate stage between monoclonal gammopathy of undetermined significance and symptomatic multiple myeloma (MM), with a significant risk of progression. Bone disease is a key feature of MM, often marking the transition to symptomatic disease. Whole-body low-dose computed tomography (WBLDCT) is an easily accessible and highly sensitive imaging modality for detecting osteolytic lesions, providing an advantage over conventional skeletal surveys. In our real-world cohort, we prospectively evaluated the role of WBLDCT in the early identification of bone progression in patients with SMM based on the recommendations by the International Myeloma Working Group. A total of 113 patients were monitored with annual WBLDCT assessments; 36.3% progressed to symptomatic MM, with 9.7% progressing solely with bone lesions, highlighting the importance of early detection. Therefore, integrating annual WBLDCT assessments into clinical practice for SMM patients is essential to facilitate treatment strategies and prevent disease-related complications. This is even more important in the upcoming era of early treatment initiation for patients with SMM at high risk for progression.
冒烟型多发性骨髓瘤（SMM）是意义未明的单克隆丙种球蛋白病和有症状的多发性骨髓瘤（MM）之间的一个中间阶段，具有显著的进展风险。骨病是MM的一个关键特征，常常标志着向有症状疾病的转变。全身低剂量计算机断层扫描（WBLDCT）是一种易于获得且高度敏感的成像方式，用于检测溶骨性病变，比传统的骨骼X线检查具有优势。在我们的真实世界队列中，我们根据国际骨髓瘤工作组的建议，前瞻性地评估了WBLDCT在早期识别SMM患者骨进展中的作用。共有113例患者接受了每年一次的WBLDCT评估；36.3%进展为有症状的MM，其中9.7%仅因骨病变进展，凸显了早期检测的重要性。因此，将每年一次的WBLDCT评估纳入SMM患者的临床实践对于促进治疗策略和预防疾病相关并发症至关重要。在即将到来的对有高进展风险的SMM患者进行早期治疗的时代，这一点尤为重要。
