How long is the journey of smoldering multiple myloma to mm does smoldering always progress to mm if so any time frame?

Various, depends: This is a highly complex q. SMM is defined as M-protein >3 g/dl and/or BM plasma cell >10% without end organ damage. It is a highly heterogeneous group of dz. On average, the risk for SMM progression to MM is 10% each yr. Some high risk SMM such as BM plasma cell >60% SMM or high FLC can progress to MM within 2 yrs. Others can be stable for 5-7 yrs (I see it). Theoretically, all will.