MM-259: Impact of the International Myeloma Working Group (IMWG) SLiM Criteria on Multiple Myeloma Management: A Tertiary Care Center Experience

Document Type

Conference Proceeding

Publication Date

9-1-2025

Abstract

Multiple myeloma (MM) is a hematologic malignancy characterized by the proliferation of plasma cells. IMWG's introduction of the SLiM criteria in 2014 expanded the diagnosis of MM. Our retrospective study evaluated the adoption and impact of these criteria at Henry Ford Cancer Institute (HFCI), focusing on patient demographics and outcomes of those diagnosed exclusively using the SLiM criteria. Methods: Electronic medical records at HFCI (January 2015–December 2023) were reviewed to identify MM patients meeting at least one SLiM criterion (≥60% plasma cells, free light chain (FLC) ratio >100, or MRI lesion), excluding those with CRAB features. Data on demographics, staging, treatment, and outcomes (through December 2024) were analyzed. Results: Between 2015 and 2023, 495MMpatients were diagnosed; 190 met at least one SLiM criterion. After excluding 177 with CRAB features, 13 patients remained who were diagnosed solely by SLiM criteria. Of these, 6 had plasma cells >60%, 11 had FLC ratio >100, and 3 met MRI criteria. The mean age was 63.6 years; 53.8% were female, 53.8% African American, and 38.4% Caucasian. High-risk cytogenetics were present in 53.8% patients. By Revised International Staging System (R-ISS) staging, 61.5% of patients had stage 1, 30.7% had stage 2, and 7.6% had stage 3 disease. Twelve patients received treatment with induction regimen, which included bortezomib, lenalidomide, dexamethasone (VRd) (n = 9), daratumumab-VRd (n = 1), carfilzomib, lenalidomide, dexamethasone (KRd) (n = 1), or bortezomib, dexamethasone (Vd) (n = 1), all starting treatment at diagnosis. Among them, there was one death (hospice, age/comorbidities), two relapses (both in remission after second-line therapy), and nine remained in remission. One patient, diagnosed in 2017, has not required treatment to date. Conclusion: Our study highlights real-world data on the impact of the IMWG SLiM criteria for MM diagnosis. Patients diagnosed solely based on SLiM criteria, who would previously have been classified as having smoldering myeloma, were treated at diagnosis, reflecting real-time adoption of the updated guidelines. This underscores the positive impact and practical applicability of the revised criteria. Interestingly, one untreated patient has not progressed, suggesting the need for appropriately powered randomized studies to better understand outcomes in this specific subset of patients.

First Page

S911

This document is currently not available here.

Share

COinS