ADVANCES IN DIAGNOSIS AND TREATMENT OF MULTIPLE MYELOMA: A MOLECULAR AND THERAPEUTIC UPDATE

Gamal Abdul Hamid*1,2, Ivan Saleh1

ABSTRACT

Multiple myeloma (MM) is a clinically and biologically heterogeneous plasma cell malignancy, representing the second most common hematologic cancer. Recent years have witnessed transformative advances in molecular diagnostics, risk stratification, and therapeutic modalities, leading to significantly improved survival outcomes. This review provides a comprehensive update on the epidemiology, molecular pathogenesis, diagnostic criteria, staging systems, and contemporary treatment paradigms of MM. Emphasis is placed on the integration of next-generation sequencing, fluorescence in situ hybridization (FISH), and minimal residual disease (MRD) monitoring into clinical practice. The advent of proteasome inhibitors, immunomodulatory drugs, monoclonal antibodies, chimeric antigen receptor (CAR) T-cell therapy, and bispecific antibodies has redefined MM management. Despite these advances, high-risk cytogenetic subgroups continue to pose therapeutic challenges. This manuscript highlights the shift toward personalized medicine in MM, discusses current clinical challenges, and outlines future research directions aimed at achieving durable remissions and potential cure.

Keywords: Multiple myeloma, MGUS, cytogenetics, proteasome inhibitors, immunomodulatory drugs, CAR-T therapy, minimal residual disease, personalized medicine.