Multiple myeloma (MM) is a heterogeneous disease for which several new treatments are available. Much has been learned about its biology over the past 15 years. We now understand that there are various subtypes of the disease, each one associated with different outcomes and clinical pathological features. While a detailed classification of the disease into at least seven or eight major subtypes is possible, a practical clinical approach classifies the disease into high-risk and not-high-risk MM. This classification has allowed for tailored approaches to therapy and treatment planning. Furthermore, the discussion of outcomes with patients should include risk stratification, as the prospects for survival are quite different depending on whether the patient has high-risk MM or not. The tools for measuring risk subcategory are widely available and now routinely employed in the clinic. The continued search for genetic abnormalities that underlie the biology of MM may allow for even better precision therapy in the future.
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