What is your preferred maintenance strategy for high risk multiple myeloma?

Ok. First off, what is high risk in the setting of maintenance therapy? I define high risk in this area as R-ISS 3 [incl t(14;20)], ≥ 5% circulating PCs, extramedullary disease [except salivary glands], hypodiploidy, or karyotypic t(8;22). We frequently argue about this definition since there is no ...

A loaded question for sure. One thing I can say with a fair amount of confidence is that most patients with high risk disease (I like the inclusive definition of high risk used in the SWOG S1211 study) will be undertreated with single agent maintenance alone. For context, the median PFS was 47 month...