Multiple myeloma in 2026 — current guidelines and new therapies

Multiple myeloma (MM) is the second most common hematologic malignancy in adults, caused by clonal plasma cell (CPs) proliferation and associated with organ damage. In recent years, diagnosis has advanced through integration of laboratory testing, bone marrow evaluation, and modern imaging such as positron emission tomography computed tomography (PET-CT) and whole-body magnetic resonance imaging (MRI). Minimal residual disease (MRD) has emer-ged as a key prognostic factor guiding therapy. Treatment outcomes have significantly improved with proteasome inhibitors, immunomodulatory drugs, and anti-CD38 monoclonal antibodies. Autologous stem cell transplantation (ASCT) remains a standard for eligible patients, supported by triplet or quadruplet induction regimens. For transplant--ineligible patients, daratumumab-based combinations are recommended. Novel immunotherapies, including bispecific antibodies, chimeric antigen receptor (CAR-T) cells, and antibody–drug conjugates (ADC), demonstrate significant efficacy in relapsed/refractory MM. Supportive care, encompassing infection prophylaxis, bone protective agents, renal management, and thromboprophylaxis is essential. Despite therapeutic progress, MM remains incurable, underscoring the need for broader access and long-term outcome optimization. In Poland, access to innovative therapies is regulated by the National Health Fund (NFZ, Narodowy Fundusz Zdrowia) drug program.