Management of newly diagnosed symptomatic multiple myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus guidelines 2013

Mayo Clin Proc. 2013 Apr;88(4):360-76. doi: 10.1016/j.mayocp.2013.01.019.


Multiple myeloma remains an incurable neoplasm of plasma cells that affects more than 20,000 people annually in the United States. There has been a veritable revolution in this disease during the past decade, with dramatic improvements in our understanding of its pathogenesis, the development of several novel agents, and a concomitant doubling in overall survival. Because multiple myeloma is a complex and wide-ranging disorder, its management must be guided by disease- and patient-related factors; emerging as one of the most influential factors is risk stratification, primarily based on cytogenetic features. A risk-adapted approach provides optimal therapy to patients, ensuring intense therapy for aggressive disease and minimizing toxic effects, providing sufficient but less intense therapy for low-risk disease. This consensus statement reflects recommendations from more than 20 Mayo Clinic myeloma physicians, providing a practical approach for newly diagnosed patients with myeloma who are not enrolled in a clinical trial.

Publication types

  • Consensus Development Conference
  • Practice Guideline

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Combined Modality Therapy
  • Genetic Markers
  • Humans
  • Immunologic Factors / therapeutic use
  • Induction Chemotherapy
  • Maintenance Chemotherapy
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / genetics
  • Multiple Myeloma / therapy*
  • Risk Assessment
  • Stem Cell Transplantation


  • Antineoplastic Agents
  • Genetic Markers
  • Immunologic Factors