Iuliana Vaxman

INTRODUCTION For decades, the diagnosis of multiple myeloma (MM) required the presence of end-organ damage attributed to the underlying plasma cell disorder, known as the Calcium elevation, Renal impairment, Anemia, Bone disease (CRAB) criteria.1 The CRAB criteria include increased calcium level, renal dysfunction, anaemia and destructive bone lesions.

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In their guidelines on the management of SMM,1 the authors do not recommend screening for MGUS/MM due to the risk of overdiagnosis and overtreatment and the psychological effects of early diagnosis. Do these guidelines really stand in 2024? The iStopMM study, recently presented at ASH 2023,2 provided additional exciting data on the benefit of a screening approach.