Treatment of Multiple Myeloma in High-Risk Smouldering Multiple Myeloma

This protocol covers the management of patients with high-risk smouldering multiple myeloma (high-risk SMM) — a defined clinical subgroup within the multiple myeloma spectrum where early therapeutic intervention is under active consideration.

Clinical scenario

High-risk smouldering multiple myeloma. Note that regulatory agency approval for treatment in this setting is pending at the time of current guideline publication.

Treatment approach

A monotherapy strategy using daratumumab is considered in patients meeting high-risk SMM criteria. Complete protocol details — including treatment duration, monitoring parameters, and eligibility criteria — are available in the structured protocol below.

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References

DOI: 10.1038/s41571-025-01041-x

Although approval by regulatory agencies is pending at the time of writing, daratumumab monotherapy for 3 years can be considered in patients with high-risk SMM [I, A].

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