- Low Risk Smoldering Multiple Myeloma
- What Tests Will I Need And Why?
Low Risk Smoldering Multiple Myeloma
A Smoldering Multiple Myeloma Low-Risk diagnosis means that abnormal plasma cells, a type of white blood cell, are multiplying more than they should and are building up in the bone marrow. It is a condition where abnormal plasma cells, a type of white blood cell, are building up in the bone marrow but aren’t causing any symptoms or damage to the body.
Low Risk means the chance of it progressing to active myeloma is small, and it may stay stable for many years. Low-risk means that tests show a smaller number of these abnormal cells or proteins compared to higher-risk cases, and your blood and organs (like your kidneys) aren’t being harmed which is why you typically don’t feel any symptoms.
The term “Smoldering” is used to reflect that the disease is “simmering” without becoming aggressive or active. Doctors typically monitor low-risk SMM to make sure it doesn’t progress.
Regular check-ups are important however to monitor the condition and check for any changes, but many individuals may not need treatment for years, as the disease can remain stable. In fact, only about 10% of people with SMM progress to active multiple myeloma each year.
Helpful terms to know:
- Plasma cells: These are a type of white blood cell that makes antibodies, which are like tiny soldiers in your body that fight germs. In SMM, some plasma cells become abnormal and start multiplying too much.
- Low-risk: This means there are fewer abnormal cells or proteins compared to higher-risk cases, and important parts of your body, like your kidneys or bones, are not being damaged.
- Smoldering: This word means that the condition is “quiet” or “simmering.”

Cancer.gov
Overview
A Multiple Myeloma diagnosis and risk level is determined using a variety of tests to see how advanced the condition is and whether it’s likely to progress. Here’s an overview of the main tests:
Blood Tests:
Complete Blood Count (CBC) checks for low levels of red blood cells, white blood cells, or platelets, which can indicate bone marrow issues.
Serum Protein Electrophoresis (SPEP) measures the level of abnormal proteins being produced by cancerous plasma cells.
Calcium Levels to determine if bone damage has been caused by multiple myeloma.
Creatinine Levels assess kidney function, which can be affected by multiple myeloma.
Urine Tests: find any abnormal proteins which are produced by abnormal plasma cells.
Bone Marrow Biopsy: primarily used to check the percentage of abnormal plasma cells verses normal plasma cells and to perform genetic testing to look for genetic abnormalities that may be linked to higher risk.
Imaging Tests: An X-ray, MRI and Pet Scan look for any bone damage or active disease.
Low Risk Smoldering Multiple Myeloma test results include:
None of the following:
1. Bone marrow plasma cells (BMPC) >20%
2. M-Protein >2g/dL
3. Serum FLC ratio >20
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