A REVIEW OF MULTIPLE MYELOMA: CURRENT PERSPECTIVE ON DIAGNOSIS AND THERAPY

Abstract

Multiple myeloma (MM) is a malignant plasma cell disorder characterized by clonal proliferation within the bone marrow and the production of monoclonal proteins, leading to significant organ dysfunction and disease burden. Despite substantial advances in diagnosis and therapy, MM remains incurable and represents the second most common hematologic malignancy worldwide. This review critically examines current perspectives on the diagnosis and management of MM, integrating findings across diagnostic innovations, therapeutic advancements, and emerging clinical challenges. Conventional diagnostic tools, including serum protein electrophoresis (SPEP) and bone marrow biopsy, remain essential but are limited in sensitivity, particularly in detecting early or asymptomatic disease stages. Recent advances in molecular diagnostics, such as next-generation sequencing (NGS) and fluorescence in situ hybridization (FISH), have significantly enhanced the accuracy of minimal residual disease (MRD) detection and risk stratification. Additionally, advanced imaging modalities, including magnetic resonance imaging (MRI) and positron emission tomography (PET), have improved the detection of bone and extramedullary involvement.

Therapeutic strategies have evolved considerably with the introduction of proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies, leading to improved survival outcomes. However, disease relapse and drug resistance remain major clinical obstacles. Novel immunotherapeutic approaches, particularly chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies, show promising efficacy in relapsed and refractory MM, although concerns regarding toxicity, accessibility, and cost persist. Overall, this review highlights a paradigm shift toward precision medicine in MM, emphasizing the role of molecular profiling in guiding individualized treatment strategies. Future directions focus on improving early detection, overcoming therapeutic resistance, and enhancing global access to advanced diagnostics and therapies to optimize patient outcomes.