[Guidelines for the diagnosis and management of multiple myeloma in China (2026 revision)]

Multiple myeloma (MM), an incurable malignancy characterized by the clonal proliferation of plasma cells, predominantly affects older adults and is the third most common hematologic malignancy in China. With the continuous emergence of novel therapeutic agents and advances in diagnostic technologies, the diagnosis and treatment of MM have progressively evolved. In this revision of the guidelines, the recommended examinations listed in the diagnostic section have been updated. In the risk-stratification section, the Chinese comprehensive risk-stratification system has been retained, and the Consensus Genomic Staging system has been added. For patients with newly diagnosed MM, quadruplet regimens containing an anti-CD38 monoclonal antibody are preferentially recommended. Nevertheless, in the era of quadruplet induction therapy, early autologous stem cell transplantation remains recommended for all transplant-eligible patients. Chimeric antigen receptor T-cell therapy and bispecific antibodies may be used in patients at first relapse, and belantamab mafodotin-based combinations have also been added to the recommendations for this population. Treatment options are assigned different levels of recommendation based on the best available evidence.