Multiple Myeloma is a type of blood cancer that develops from plasma cells, which are a specific type of white blood cells important in normal defences against pathogens through the production of specific antibodies. It mostly presents in patients over 40 years old, however can rarely present in younger people. Traditional symptoms include anaemia, renal failure, bone pain with bone lesions and hyper-calcaemia, sometimes accompanied by repeated infections and AL Amyloidosis.

There are two conditions that are defined as precursors to Multiple Myeloma, Monoclonal Gammopathy of Undetermined Significance (MGUS), and a more advanced precursor called Smouldering Multiple Myeloma. The risk of progression from MGUS to Multiple Myeloma has been found to be 1% per year and for Smouldering Multiple Myeloma the risk of progression to Multiple Myeloma is 10% per year during the first five years¹.

Some studies have found that patients diagnosed with a precursor condition and consequently followed up by regular monitoring have a superior survival rate than patients diagnosed only after progression to Multiple Myeloma. However, at present only 2.7 to 6% of Multiple Myeloma patients are diagnosed in a precursor stage coincidently when the patient is being investigated for another reason^2-4.

These facts raise two important questions:

• Is population-based screening for MGUS beneficial for patients?
• What’s the optimum monitoring approach for patient management?

The Iceland Screens, Treats, or Prevents Multiple Myeloma study (iStopMM) is the first population-based screening study for MGUS which includes a randomised trial of follow-up strategies designed to answer these key questions.