How to Define High-Risk Smoldering Myeloma

How do you define high-risk smoldering myeloma? And then I know a lot of folks are saying, you don't treat outside of a clinical trial. Well, the challenge with many of the large randomized trials is that we keep moving the definition. So understanding which patients really got benefit from early intervention sometimes becomes a little challenging. High risk means your risk of progressing to symptomatic myeloma within two years is between 50 and 70%.