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What is the Difference Between Smoldering Myeloma and Multiple Myeloma

May 29, 2023 Posted by Dr.Samanthi

The key difference between smoldering myeloma and multiple myeloma is that smoldering multiple myeloma is a plasma cell cancer that doesn’t show any signs and symptoms, while multiple myeloma is a plasma cell cancer that may or may not show signs and symptoms.

Multiple myeloma is a plasma cell cancer. In multiple myeloma, the production of myeloma cells or abnormal plasma cells primarily occurs within the bones and bone marrow. There are two main types of multiple myeloma: smoldering and active. Smoldering multiple myeloma (smoldering myeloma) is asymptomatic, while active multiple myeloma is symptomatic.

CONTENTS

1. Overview and Key Difference
2. What is Smoldering Myeloma 
3. What is Multiple Myeloma
4. Similarities – Smoldering Myeloma and Multiple Myeloma
5. Smoldering Myeloma vs Multiple Myeloma in Tabular Form
6. Summary – Smoldering Myeloma vs Multiple Myeloma

What is Smoldering Myeloma?

Smoldering myeloma is a slow-growing type of multiple myeloma that is asymptomatic in nature. This means it does not cause any symptoms. This is a very rare type of cancer. However, in smoldering myeloma, people have high numbers of plasma cells in their bone marrow and a high level of M proteins in their blood and urine. Smoldering myeloma is very similar to another condition called monoclonal gammopathy of undetermined significance (MGUS). The actual cause of smoldering myeloma is not known. But the risk factors for this condition may include gene mutations, age (between 50 to 70), gender (males affected more), race (African American affected more), and obesity.

Smoldering Myeloma vs Multiple Myeloma in Tabular Form

Figure 01: Smoldering Myeloma

Smoldering myeloma is diagnosed through blood and urine tests (to test high levels of M protein and high levels of plasma cells), bone marrow biopsy, skeletal survey, MRI, and X-ray. Furthermore, there may not need any treatment for smoldering multiple myeloma. However, people must involve in regular clinical trials in order to assess the risk state.

What is Multiple Myeloma?

Multiple myeloma is the most common type of plasma cell cancer. It can be asymptomatic or symptomatic, depending on the type of multiple myeloma. There are two main types of multiple myeloma; smoldering and active. As mentioned above, smoldering multiple myeloma (smoldering myeloma) is asymptomatic, while active multiple myeloma is symptomatic. When the signs and symptoms appear, they may include bone pain, mainly in the spine or chest, nausea, constipation, loss of appetite, mental confusion, fatigue, frequent infections, weight loss, weakness or numbness, especially in the legs, and excessive thirst. Moreover, it is not clear what causes myeloma. However, multiple myeloma always starts out as a relatively benign condition called monoclonal gammopathy of undetermined significance (MGUS). The risk factors for this condition include increasing age (most probably affected in the mid-60s), male sex, black race, family history, and personal history of a monoclonal gammopathy of undetermined significance (MGUS).

Smoldering Myeloma and Multiple Myeloma - Side by Side Comparison

Figure 02: Multiple Myeloma

Multiple myeloma can be diagnosed through blood tests, urine tests, examination of bone marrow, and imaging tests such as MRI, X-ray, and PET scan. The treatment options for multiple myeloma may include targeted therapy, immunotherapy, chemotherapy, corticosteroids, bone marrow transplant, and radiation therapy.

What are the Similarities Between Smoldering Myeloma and Multiple Myeloma?

  • Smoldering myeloma and multiple myeloma are two associated plasma cell cancers.
  • Smoldering myeloma is a type of multiple myeloma.
  • They are rare types of cancers.
  • Both are characterized by high levels of plasma cells and M proteins.
  • Both can be diagnosed through blood tests, urine tests, and imaging tests such as MRI, X-ray, and PET scans.

What is the Difference Between Smoldering Myeloma and Multiple Myeloma?

Smoldering multiple myeloma is a plasma cell cancer that is asymptomatic, while multiple myeloma is a plasma cell cancer that may or may not have signs and symptoms. Thus, this is the key difference between smoldering myeloma and multiple myeloma. Furthermore, smoldering multiple myeloma is slow growing, whereas multiple myeloma can be slow growing or fast-growing.

The below infographic presents the differences between smoldering myeloma and multiple myeloma in tabular form for side-by-side comparison.

Summary – Smoldering Myeloma vs Multiple Myeloma

Plasma cell cancers or neoplasms are diseases in which the body makes too many plasma cells. They can be benign or malignant. Smoldering myeloma and multiple myeloma are two related rare types of plasma cell cancers. This is because smoldering myeloma is a type of multiple myeloma. The other type of multiple myeloma is active multiple myeloma. Moreover, smoldering multiple myeloma doesn’t show signs and symptoms, meaning that it is asymptomatic. Multiple myeloma may or may not have signs and symptoms. So, this is the key difference between smoldering myeloma and multiple myeloma

Reference:

1. “Multiple Myeloma.” Mayo Clinic.
2. “Smoldering Multiple Myeloma: Symptoms, Causes, Diagnosis, Treatment.” WebMD.

Image Courtesy:

1. “Plasma Cells in Multiple Myeloma Patient” By Dr Erhabor Osaro – Own work (CC BY-SA 3.0) via Commons Wikimedia
2. “Multiple Myeloma” By Scientific Animations (CC BY-SA 4.0) via Commons Wikimedia

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Filed Under: Diseases

About the Author: Dr.Samanthi

Dr.Samanthi Udayangani holds a B.Sc. Degree in Plant Science, M.Sc. in Molecular and Applied Microbiology, and PhD in Applied Microbiology. Her research interests include Bio-fertilizers, Plant-Microbe Interactions, Molecular Microbiology, Soil Fungi, and Fungal Ecology.

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