*6.10.2 Treatment and prognosis*

The prognosis is variable but has improved in recent years with new therapeutic approaches. The median survival is 4–7 years. Translocations involving cyclin D1 are associated with a good outcome, whereas deletions of 13q, deletions of 17p, and the t(4;14) are associated with more aggressive course. Hematopoietic stem cell transplantation prolongs life but has not yet proven to be curative. Solitary osseous plasmacytoma almost inevitably progresses to multiple myeloma but can take 10–20 years or longer. In contrast, extraosseous plasmacytomas, particularly those involving the upper respiratory tract, are frequently cured by local resection. About 75% of patients of smoldering myeloma progress to multiple myeloma over a 15-year period. Approximately 1% of patients with MGUS develop asymptomatic plasma cell neoplasm, usually multiple myeloma, per year, a rate of conversion that remains roughly constant over time [1, 25, 68].
