What is the definition of high-risk multiple myeloma (HRMM)?

[Music] what does it mean if you have high risk myeloma if you're considered to be high-risk disease or you're told that your myeloma is high-risk disease basically what it's telling you is that the myeloma that you're that you have is going to be more likely to want to come back sooner so if you respond to treatment and you achieve a good control of your disease it's going to probably come back sooner than somebody who does not have high-risk disease why is that important that's important because high-risk disease it's harder to treat sometimes it's harder to achieve a good remission and then if it is controlled or if we manage to do the blocking of the disease it's going to want to come back sooner rather than later and that translates to having to need more chemotherapy to try to control the disease better and it also means that the risk of surviving myeloma is less uh you're gonna have a less probability of surviving myeloma than somebody who's standard risk so all the studies that have been done to compare the two different types of risk categories high risk versus standard risk has shown that high-risk disease people who have this type of disease are gonna relapse much sooner and that they're going to have a shorter survival or outcome so people are gonna live longer if they're standard risk and are going to have a better control of their disease compared to high-risk disease does all high-risk disease behave in the same way now having said that if somebody is established to have high-risk disease or has been told that they have high-risk disease based on their cytogenetics or based on the staging or other criteria that defines them as high-risk disease it doesn't necessarily mean that that's it that you are going to behave like high risk and your disease is going to be hard to control and that your outcome is not going to be that good you're not doomed it's just a predictor so we're not gods and we can't see the future these tools that we use to define somebody as being high risk or standard risk are just guides to help us see what the odds are in the future but it doesn't necessarily mean that you're going to follow that criteria and i see in clinic people who have high-risk disease with 17p deletion that stays in remission for years and we have other patients in clinic who don't even have any mutations and they are having a hard time to achieve a remission with conventional chemotherapy so i want to emphasize that because it's important to keep this in mind but it doesn't necessarily define what your future is going to be like it's just a predictor of what we could possibly expect based on what we've seen with prior patients or prior clinical trials that we have done