Multiple Myeloma: Risk Stratification and Management

Multiple myeloma is the second most common hematological malignancy. Rapid strides in prognostication and therapy have dramatically improved survival. The revised IMWG diagnostic criteria has already expanded the definition of MM. Molecular cytogenetic classification and the subsequent genetic risk stratification have helped to better define the disease and take appropriate therapeutic decisions in the various risk groups. WB PET CT scan has provided a quick and complete assessment of bone and extramedullary disease and is being increasingly used in place of whole body MRI. Minimal Residual Disease assessment is helping refine the intensity and duration of therapies, thereby reducing adverse drug effects. Phenomenal breakthroughs in the field of immunotherapy, in the form of CAR T cell therapy and BiTE antibodies, are providing new avenues of therapy to relapse-refractory disease patients post multiple lines of therapy. This article summarizes the current status of diagnostic workup, risk stratification, and therapeutic approaches in multiple myeloma.