Table 4.

Baseline assessment and monitoring for patients with SMM

TestAt baselineHow often do we repeat it
CBC Yes 3-6 mo 
Vitamin B12, TSH, folic acid, iron, transferrin, and ferritin Yes When hemoglobin decreases 
Creatinine Yes 3-6 mo 
Calcium Yes 3-6 mo 
Alkaline phosphatase Yes 12 mo 
24-h urinary protein Yes 12 mo 
NT-proBNP and troponin Yes 12 mo 
SPEP and IEP Yes 3-6 mo 
sFLC Yes 3-6 mo 
Skeletal imaging PET-CT (if unavailable, we recommend TBLDCT and MRI of spine and pelvis) TBLDCT every 6-12 mo if monoclonal protein is rising 
BM biopsy and aspirate and FISH Yes When progression is suspected 
TestAt baselineHow often do we repeat it
CBC Yes 3-6 mo 
Vitamin B12, TSH, folic acid, iron, transferrin, and ferritin Yes When hemoglobin decreases 
Creatinine Yes 3-6 mo 
Calcium Yes 3-6 mo 
Alkaline phosphatase Yes 12 mo 
24-h urinary protein Yes 12 mo 
NT-proBNP and troponin Yes 12 mo 
SPEP and IEP Yes 3-6 mo 
sFLC Yes 3-6 mo 
Skeletal imaging PET-CT (if unavailable, we recommend TBLDCT and MRI of spine and pelvis) TBLDCT every 6-12 mo if monoclonal protein is rising 
BM biopsy and aspirate and FISH Yes When progression is suspected 

CBC, complete blood count; IEP, immunofixation; NT-proBNP, N-terminal probrain natriuretic peptide; SPEP, serum protein electrophoresis; TBLDCT, total-body low-dose CT scan; TSH, thyroid-stimulating hormone.

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