Functional High-Risk Versus Standard-Risk Multiple Myeloma

In this segment, Dr. Ajay Nooka asks Dr. Surbhi Sidana to discuss how functional high-risk multiple myeloma is defined in clinical practice and how it influences treatment decisions. Dr. Sidana explains that functional high-risk disease is often characterized by features such as early relapse, aggressive disease behavior, or limited durability of response to prior therapies, even in the absence of traditional high-risk cytogenetics. She highlights how these patients may require more urgent intervention and careful treatment selection. In contrast, patients with standard-risk disease at first relapse may allow for a more measured sequencing approach, depending on disease trajectory and prior treatment response. The discussion emphasizes the importance of distinguishing between biologic and functional risk when guiding management. This segment underscores how risk stratification plays a critical role in tailoring treatment strategies in relapsed and refractory multiple myeloma.