High-Risk Smoldering Multiple Myeloma: A Review of Controversies in Early Treatment Versus Observation

This review addresses the ongoing debate regarding the management of high-risk smoldering multiple myeloma (SMM), particularly the efficacy of early treatment versus observation. The authors highlight recent advancements in risk stratification and the approval of daratumumab for high-risk SMM, which challenges traditional watch-and-wait strategies. They emphasize the need for a patient-centered approach, recognizing that while early intervention may benefit some patients, careful selection is crucial to avoid overtreatment.