IMS and IMWG consensus recommendations on the Definition of High-Risk Multiple Myeloma

The International Myeloma Society and International Myeloma Working Group have published updated consensus recommendations on the definition of high-risk myeloma.

While outcomes have improved with modern triplet and quadruplet treatments, a proportion of patients continue to experience early relapse and poorer survival. Traditional risk models do not fully reflect prognosis in contemporary practice.

This new consensus revisits the definition of high-risk myeloma and introduces a Consensus Genomic Staging framework. High-risk disease is defined by specific genomic abnormalities, including:

• del(17p) greater than 20% and/or TP53 mutation
• High-risk IgH translocations with 1q gain and/or del(1p32)
• Combined 1p32 abnormalities
• Elevated β2 microglobulin with normal creatinine

The aim is to provide a more precise, genomically informed approach to risk stratification in routine care and clinical trials.