Prognosis of asymptomatic multiple myeloma.

Prognostic factors were assessed in 35 consecutive, asymptomatic patients with multiple myeloma. The presence of any lytic bone lesion or a serum myeloma protein concentration of at least 3.0 g/dL was followed by early disease progression and the need for chemotherapy within two years. Such patients require frequent monitoring of electrophoretic data. In patients without these features, the myeloma did not progress for a median of three years and the subsequent median survival time was seven years, identifying those likely to live for ten years after diagnosis. Because the treatment of myeloma remains palliative, chemotherapy should be withheld until symptoms develop or complications are imminent.