20/2/20 Risk Score for Smouldering Myeloma
Predicts 2-year progression risk from smouldering (asymptomatic) myeloma to symptomatic multiple myeloma using the 20/2/20 model.
Score interpretation
Score 0: ~5.6% 2-year progression risk to symptomatic myeloma.
→ Watch and wait. Monitor every 6 months (blood counts, protein electrophoresis, renal function).
Score 1: ~17.9% 2-year progression risk.
→ Closer monitoring (every 3–4 months). Consider clinical trial enrolment. Bone survey/PET-CT.
Score 2–3: ~43.7% 2-year progression risk.
→ High risk. Discuss early treatment (daratumumab-based) or clinical trial. Monitor every 3 months. Bone MRI.
Interpretation bands for the Smouldering Myeloma 20/2/20. Apply clinical judgement and local guidance.
References
- Rajkumar SV et al. Smoldering multiple myeloma. Blood. 2020;135(21):1851-1858.
Related
Curated clinical cross-links plus same-class fallbacks.
- Dairy products · Nutritional source (calcium, protein, vitamin D)
- Bortezomib · Proteasome Inhibitor — Myeloma
- Thalidomide · Immunomodulatory Drug (IMiD) — Myeloma
- Daratumumab · Anti-CD38 Monoclonal Antibody — Myeloma
- Protein C (Specialist drug) · Recombinant/plasma-derived protein C concentrate
- Respiratory syncytial virus (RSV) vaccine · RSV pre-fusion F protein vaccine
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.