If you treat a patient with high-risk smoldering myeloma on trial and they develop biochemical progression by M-spike, but still no CRAB-SLiM criteria, what would you do next?

My personal preference is to not treat smoldering myeloma.

One of the reasons for this is you fall into this very conundrum.

The decision to treat was made while the patient was asymptomatic and without end-organ damage. The patient is now in the exact same scenario, so why should the decision-making ...