Hello, my name is Maria Victoria Mateos. I work as a hematologist and a director of the Myeloma unit at the University Hospital of Salamanca in Spain. And I will present the challenges and the future directions in monoclonal ganmopathy as well as smoldering myeloma, two precursors of diseases that always precede to multiple myeloma. The first challenge is the diagnosis and in 2014 the diagnosis criteria for multiple myeloma were updated and in order to do the diagnosis of M. gas or smoldering myeloma it is extremely important to ruling out the presence of myeloma defining event and also it is important to wait at least three or six months in order to confirm the stabilization of the end component as well as the absence of crab symptomatology for doing the diagnosis of M. gas and smoldering. In the future maybe we will expand the definition of multiple myeloma by the incorporation of new biomarkers that will predict in asymptomatic myeloma patients imminent risk of progression to multiple myeloma. The second challenge is screening programs yes or not and based on the I-STOP multiple myeloma project we have not yet to budget screening programs for the early detection of either M. gas or smoldering but maybe based on the high prevalence reported in this observational study especially for smoldering 0.5 percent of the population older than 40 and especially because the screening changes the way in which the disease is presented and we are going to avoid acute presentations and we are going to avoid crab symptomatology in our myeloma patients. I think that in the future maybe we can have screening programs. The third challenge is how to stratify especially smoldering myeloma patients according to the risk of progression to multiple myeloma and it is well accepted that the use of clinical markers like the M component the plasma cell bone marrow infiltration and the free-light chain ratio including the 2020 model is a valid and worldwide model to stratify patients with smoldering myeloma. New approaches are coming based on genomic information that will complement these clinical markers that we have to use every day in our patients with smoldering because it is mandatory to evaluate the risk of progression to myeloma. The other important challenge is to plan early treatment yes or not. Point number one there is not any drug approved yet for smoldering myeloma but there are some evidence at least two academic phase three clinical studies reporting benefit for the early treatment with the land of lendex in this population high risk smoldering myeloma. Many clinical trials are coming and we will have in the future drugs approved for high-risk smoldering myeloma monoclonal antibodies anti-cd38 like Dara single agent or maybe Dara or isotoxin in combination with lendex but of course the new immunotherapy strategies like bispecific monoclonal antibodies and CAR-T are also coming to the treatment of smoldering myeloma patients patients in which the immune system will be better than in myeloma and maybe the efficacy will be also superior. Also another challenging we say we have to work is in the primary objective we want to just to delay the progression to myeloma or maybe we want to eradicate completely the disease to cure the disease and I would like to summarize saying that many basic translational and clinical research is ongoing in mGAS and especially in high-risk smoldering myeloma so I am completely confident with all these efforts we are doing in order to plan early treatment for high-risk smoldering myeloma at least for delaying the progression to multiple myeloma but maybe we will be able to cure the disease in some of these patients.