Hello and good morning, good afternoon. My name is Katja Weisel. I'm from the University Medical Center in Hamburg-Eppendorf in Hamburg in Germany and I'm very happy to be guest here in the International Myeloma Week which takes place this year in Rio de Janeiro in Brazil. I'm just coming out of the session of treatment of high-risk myeloma disease and it was a very inspiring session. We learned several things and my personal talk was about what we learned how to treat high-risk disease out of the most recent clinical trials. So what we can look on is that there were three main academic trials. So investigator-initiated trials focusing solely of treating patients with high-risk myeloma disease defined mainly by the cytogenetic risk factor so that we can say about 20% of the newly diagnosed myeloma patients were considered at high risk and then could enter those trials. All three trials, our German concept trial, the UK optimum trial and the French IFM 2018-04 trial then started with a quadruplet induction so took together the anti-CD38 monoclonal antibody proteasome inhibitor immunomodulating agent and dexamethasone to start mainly with an extended six cycle induction. In our trial we've chosen the regimen consisted of isotoxymab, carfilzomab, lenalidomide and dexamethasone and did that for six cycles. Transplant eligible patients in all three trials then underwent high-dose myeloma and otolibus stem cell transplantation in the French trial and there was a tandem transplant performed. And the unique feature of all three trials focusing on treatment of high-risk patients was that we had an extended consolidation treatment close to the induction treatment given and all patients received combination maintenance. In our concept trial we used three drug combination maintenance consisting out of a stretched regimen of isotoxymab, lenalidomide and carfilzomab. And we saw in all three trials that we could markedly improve the prognosis of high-risk patients so that we now could say that about the median progression free survival will be beyond 70 months. And this is a significant progression because when we started with those trials those median progression data we had on high-risk patients were around 20 months. But now we went back and looked on what was the success of our trial and why were we successful. And one thing is that we are convinced that all high-risk patients need really we say a broad and early hit. We need a quadruplet regimen to bring rapidly the tumor and the myeloma burden down. High dose muffler treatment and autologous stem cell transplantation is still the gold standard for all patients eligible. Whether a tandem transplant is needed we have no clear data but it should be considered and discussed with the treating physician. But what we are convinced on is that all patients with high-risk disease should receive consolidation and a combination maintenance so that we keep the pressure on the myeloma disease and that we prevent patients that resistant clones escape and are leading to a relapse which might be difficult to treat. So this is what we learned. We clearly have to move on because there's always room to improve. The key message I would like to give you is if you have high-risk disease you need quadruplets, you need an MRD negative remission and you need combination treatment for long time to maintain this MRD negativity. We call it sustained MRD negativity and this is the key that prognosis is improved.