Since the publication in 2021 of the European Hematology Association (EHA) Clinical Practice Guidelines for the treatment of patients with smouldering multiple myeloma (SMM) and multiple myeloma (MM), developed in collaboration with the European Society for Medical Oncology, a novel international staging system (R2-ISS) has been developed, several prognostic factors are entering clinical practice (such as minimal residual disease, circulating plasma cells and monoclonal protein assessed by mass spectrometry) and, at the time of writing, 14 novel regimens have been approved by the EMA and/or the FDA for the treatment of patients with MM. A multidisciplinary group of experts from the EHA and European Myeloma Network, based in various institutions mostly located in Europe, have updated the previous guidelines and produced algorithms for everyday clinical practice that incorporate levels of evidence and grades of recommendation based on the aforementioned new data. In these Evidence-Based Guidelines, we provide key treatment recommendations for both patients with newly diagnosed MM and those with relapsed and/or refractory MM, including guidance for the use of established drugs as well as contemporary immunotherapies. Novel approaches for the management of patients with SMM focus on those who might require early intervention. Finally, we provide recommendations for myeloma-related complications and adverse events, such as bone disease, renal impairment and infections, as well as for those associated with T cell-mobilizing therapies, such as cytokine-release syndrome and immune effector cell-associated neurotoxicity syndrome.

Ankara Liv Hospital Istinye University Ankara Turkey

Australian Centre for Blood Diseases Monash University Melbourne Victoria Australia

Centre de Recherche Saint Antoine INSERM UMRs938 Sorbonne Université Paris France

Clinic of Hematology University Clinical Center of Serbia Medical Faculty University of Belgrade Belgrade Serbia

Clinica Universidad de Navarra CIMA IDISNA CIBERONC Pamplona Spain

Department of Biotechnology and Health Science University of Torino Turin Italy

Department of Clinical Therapeutics School of Medicine National and Kapodistrian University of Athens Athens Greece

Department of Haematology The Royal Marsden Hospital London UK

Department of Hemato Oncology University Hospital Ostrava Ostrava Czech Republic

Department of Hematology Amsterdam UMC Vrije Universiteit Amsterdam Cancer Center Amsterdam Amsterdam Netherlands

Department of Hematology and Bone Marrow Transplantation Poznan University of Medical Sciences Poznań Poland

Department of Hematology and Oncology Interdisciplinary Cancer Center and Comprehensive Cancer Center Freiburg University of Freiburg Faculty of Freiburg Freiburg Germany

Department of Hematology Erasmus MC Cancer Institute Rotterdam Netherlands

Department of Hematology Lille University Hospital Lille France

Department of Hematology University Hospital Hôtel Dieu Nantes France

Department of Hematology University Hospital Leuven Leuven Belgium

Department of Internal Medicine 2 University Hospital Wurzburg Wurzburg Germany

Department of Malignant Hematology and Stem Cell Transplantation The Alfred Hospital Melbourne Victoria Australia

Department of Medical Oncology and Hematology HOCH Health Ostchweiz St Gallen Switzerland

Department of Oncology Hematology and BMT University Medical Center Hamburg Eppendorf Hamburg Germany

Dipartimento di Scienze Mediche e Chirurgiche Università di Bologna Bologna Italy

Division of Genetics and Epidemiology The Institute of Cancer Research London UK

Faculty of Medicine University Hospital Ostrava Ostrava Czech Republic

Heidelberg Myeloma Center Department of Internal Medicine 5 Heidelberg University Hospital and Faculty Heidelberg Germany

Hematology Oncology Clinic Tartu University Tartu Estonia

INSERM UMR S1277 and CNRS UMR9020 Lille France

IRCCS Azienda Ospedaliero Universitaria di Bologna Istituto di Ematologia Seràgnoli Bologna Italy

Leeds Cancer Centre Leeds Teaching Hospitals NHS Trust Leeds UK

Leeds Institute of Clinical Trial Research University of Leeds Leeds UK

Oslo Myeloma Center Department of Hematology Oslo University Hospital Oslo Norway

Service d'Hématologie Clinique et de Thérapie Cellulaire Hôpital Saint Antoine AP HP Paris France

Université de Toulouse Centre Hospitalo Universitaire Institut Universitaire du Cancer Toulouse Oncopole Toulouse France

University Division of Hematology AOU Città della Salute e della Scienza di Torino Turin Italy

University Hospital of Salamanca IBSAL Cancer Research Center Salamanca Spain

Wilhelminen Cancer Research Institute 1st Department of Medicine Center for Oncology Hematology and Palliative Care Clinic Ottakring Vienna Austria

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