Rethinking Early Myeloma Care: Is Transplant Still Necessary? | Jorge Monge, MD

Dr. Jorge Monge, who directs the Multiple Myeloma Autologous Stem Cell Transplant and Myeloma Cellular Therapies Program at the University of Colorado, gives a comprehensive overview of how myeloma specialists diagnose and treat multiple myeloma today. He explains the CRAB and SLiM criteria used to distinguish smoldering myeloma from active disease, how fitness, overall health, and access to a transplant center shape treatment decisions, and when early treatment with daratumumab makes sense for high-risk smoldering myeloma based on results from the AQUILA trial. Dr. Monge also covers what's still unknown about treating early, the new 2025 genomic risk staging system for high-risk myeloma, and recent clinical trial data (MIDAS and Revlimid maintenance trials) questioning whether every standard-risk patient still needs a stem cell transplant or indefinite maintenance therapy, plus where CAR-T and bispecific antibodies may fit in as alternatives.