We thank Biran et al¹ for commenting on our study. We reported on the largest randomized trial conducted in smoldering multiple myeloma (SMM), and our recommendations are based on our trial results² as well as those previously reported by the Spanish group.³ Collectively, the two trials clearly show that we can prolong time to end-organ damage with lenalidomide-based therapy. Although some patients had baseline changes on magnetic resonance imaging, they did not meet current criteria for myeloma and would be considered SMM and observed outside of a clinical trial setting. The authors make three major points, and we are happy to provide our responses.

中文翻译：

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回复N. Biran等

我们感谢Biran等人¹对我们的研究发表评论。我们报告了在阴燃多发性骨髓瘤（SMM）中进行的最大的随机试验，我们的建议是基于我们的试验结果²以及西班牙小组先前的报道。³两项试验共同表明，使用来那度胺为基础的治疗可以延长终末器官损害的时间。尽管有些患者的磁共振成像发生了基线变化，但他们不符合当前的骨髓瘤标准，因此将其视为SMM并在临床试验环境之外进行观察。作者提出了三个主要观点，我们很高兴提供我们的回应。