The Mayo-2018 smoldering multiple myeloma (SMM) risk score is used routinely in the clinical setting but has only been validated at diagnosis. In SMM patients, the progression risk decreases over time. However, the utility of applying risk stratification models after diagnosis is unknown. We retrospectively studied 704 SMM patients and applied the Mayo 2018 and IMWG-2020 risk stratification models at annual landmark timepoints up to 5 years post diagnosis. The Mayo-2018 and IMWG-2020 models reliably stratified patients based on progression risk when applied post diagnosis. The respective 2-year progression risk in Mayo-2018 high risk patients versus IMWG-2020 intermediate-high risk patients was 51% versus 62% at the 1-year landmark and 47% versus 45% at the 4-year landmark. We showed that patients categorized at Mayo-2018 high-risk at follow-up had a similar risk of progression if the baseline risk assessment was low-intermediate versus high-risk (HR 1.04, 95% CI 0.46–2.36, p = 0.931 at 5-year landmark). Patients migrating to a higher risk category during follow up had a higher progression risk compared to patients with stable/decreased risk categorization. Our findings support the use of these risk scores post-diagnosis and suggest that patients evolving to a high-risk category may benefit from early intervention therapeutic approaches.

Mayo-2018 阴燃型多发性骨髓瘤 (SMM) 风险评分在临床环境中常规使用，但仅在诊断时得到验证。在 SMM 患者中，进展风险随时间降低。然而，诊断后应用风险分层模型的效用尚不清楚。我们回顾性研究了 704 名 SMM 患者，并在诊断后长达 5 年的年度里程碑时间点应用 Mayo 2018 和 IMWG-2020 风险分层模型。Mayo-2018 和 IMWG-2020 模型在诊断后应用时根据进展风险可靠地对患者进行分层。Mayo-2018 高风险患者与 IMWG-2020 中高风险患者的 2 年进展风险在 1 年里程碑时分别为 51% 和 62%，在 4 年里程碑时分别为 47% 和 45%。p  = 0.931 在 5 年里程碑）。与具有稳定/降低风险分类的患者相比，在随访期间迁移到更高风险类别的患者具有更高的进展风险。我们的研究结果支持在诊断后使用这些风险评分，并表明演变为高风险类别的患者可能会受益于早期干预治疗方法。