Clinical practice guidelines for multiple myeloma (MM) were co-developed in 2021 by the European Hematology Association (EHA) and the European Society for Medical Oncology. Since then, a new staging system for highrisk MM has been published, new methods have been developed for prognosis, and novel treatment regimens have been approved for both newly diagnosed and relapsed or refractory disease. The aims of this article were to provide up-to-date recommendations on the management of MM and to propose practical treatment algorithms.

As drug combinations have extended the lives of patients with multiple myeloma (MM), future trials that rely on survival endpoints will need large sample sizes and long follow-ups to observe statistically or clinically meaningful treatment effects. It is therefore important to identify surrogate endpoints that can predict long-term benefit at an earlier timepoint and thus expedite drug development. The aim of this study was to investigate whether minimal residual disease-negative complete response (MRD-CR) can be used as an intermediate surrogate endpoint for progression-free survival (PFS) and overall survival (OS) in patients with various types of MM.

Studies have shown that adding an anti-CD38 monoclonal antibody to standard therapies can improve outcomes in patients with newly diagnosed multiple myeloma (NDMM) who are ineligible for autologous haematopoietic stem-cell transplantation. However, most regimens use long-term corticosteroids, which increases the infection risk, especially in older patients. The aim of this study was to evaluate the safety and activity of isatuximab, bortezomib and lenalidomide, with limited use of dexamethasone, in patients with transplant-ineligible NDMM, including those older than 79 years.

High-risk multiple myeloma is difficult to identify and manage, partly because there is a lack of uniformity in either criteria or thresholds for specific markers of the condition. Moreover, traditional prognostic factors for multiple myeloma are not suitable in the current era of triplet and quadruplet therapies and new molecular and genomic risk factors are emerging. Consequently, the International Myeloma Society and the International Myeloma Working Group convened an expert panel to develop a practical consensus definition of high-risk multiple myeloma that takes into account new evidence from molecular and genomic assays, updated clinical data and contemporary approaches to risk stratification. The aim of this paper was to report on this consensus definition and its implications.