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Multiple Myeloma

GMJ News knowledge hub · last reviewed August 2026 · Georgian Medical Journal

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Multiple myeloma — a malignancy of plasma cells in the bone marrow causing bone destruction, renal failure, hypercalcaemia and anaemia — caused 176,404 new cases and 117,077 deaths in 2020, with incidence rising globally as populations age (IARC GLOBOCAN 2020). Multiple myeloma has been transformed by a succession of therapeutic revolutions: proteasome inhibitors (bortezomib), immunomodulatory drugs (lenalidomide), anti-CD38 monoclonal antibodies (daratumumab — most impactful recent addition to first-line therapy), and now BCMA-directed CAR-T cells and bispecific antibodies — extending median survival from approximately 3 years to potentially 10+ years in younger patients.

Key messages

176K cases — 117K deaths per year
Multiple myeloma caused 176,404 new cases and 117,077 deaths in 2020 — a malignancy of plasma cells that is rarely cured but increasingly manageable as a chronic disease with modern therapy (IARC GLOBOCAN 2020).
Daratumumab transforms first-line therapy
The addition of daratumumab (anti-CD38 monoclonal antibody) to standard triplet therapy (bortezomib + lenalidomide + dexamethasone — VRd or DRd) has dramatically improved depth of response and progression-free survival in transplant-eligible and ineligible patients alike.
BCMA-directed therapies — a new era
BCMA (B-cell maturation antigen) — expressed on myeloma cells — is now targeted by three classes: antibody-drug conjugates (belantamab mafodotin); CAR-T cells (ide-cel, cilta-cel — achieving deep responses in heavily pre-treated patients); and bispecific antibodies (teclistamab, talquetamab — off-the-shelf monthly injections).
MRD — the new treatment goal
Measurable residual disease (MRD) negativity — the absence of detectable myeloma cells at very high sensitivity (>10⁻⁵) by bone marrow flow cytometry or next-generation sequencing — is the most powerful prognostic marker and emerging treatment target in myeloma.
Not curable in most patients
Most myeloma patients are not cured with current therapy and eventually relapse. The goal is deep prolonged remission — with each successive line of therapy. Autologous stem cell transplantation remains the standard for eligible patients.
Black populations at double risk
Black/African-ancestry populations have approximately twice the multiple myeloma incidence of white populations — the most striking racial disparity in haematological malignancy. The mechanism is incompletely understood.

Key statistics

176K
new myeloma cases/year (2020)
IARC GLOBOCAN
117K
myeloma deaths/year (2020)
IARC GLOBOCAN
2x
higher myeloma incidence in Black vs white populations
Research
>10yr
median survival in younger patients with modern therapy (projected)
ASH/ESMO
3 classes
of BCMA-directed therapies now approved
FDA/EMA
65
median age at diagnosis
SEER/GLOBOCAN

Multiple myeloma — median survival by treatment era

Source: Published survival data. Each therapeutic revolution extended survival. MRD-negative era continues.

Glossary of key terms

Plasma cells and myeloma
WHOMultiple myeloma is a malignancy of long-lived plasma cells — the antibody-secreting cells of the immune system — accumulating in bone marrow, secreting a monoclonal immunoglobulin (M-protein), and causing bone destruction, kidney damage, anaemia and immunosuppression.
CRAB criteria
WHO/IMWGThe clinical criteria defining myeloma requiring treatment: hyperCalcaemia (>11.5 mg/dL); Renal impairment (creatinine >2 mg/dL); Anaemia (Hb <10 g/dL); Bone lesions (≥1 osteolytic lesion or pathological fracture). Plus biomarker criteria (clonal BM plasma cells ≥60%, FLC ratio ≥100, MRI lesions ≥2).
Daratumumab (Darzalex)
FDA/EMAA human anti-CD38 monoclonal antibody — the most impactful myeloma treatment of the past decade. Added to triplet therapy (VRd → DVRd; Rd → DRd) dramatically improves progression-free survival and depth of response across transplant-eligible and ineligible patients. Now standard of care in first-line and multiple relapsed settings.
BCMA (B-cell maturation antigen)
ResearchA surface antigen expressed on plasma cells and mature B-cells — universally expressed on myeloma cells. The most important therapeutic target in myeloma: targeted by CAR-T cells (ide-cel/Abecma, cilta-cel/Carvykti), bispecific antibodies (teclistamab/Tecvayli, elranatamab) and antibody-drug conjugates (belantamab mafodotin).
Autologous stem cell transplant (ASCT)
ESMO/ASHHigh-dose melphalan followed by infusion of the patient's own previously harvested haematopoietic stem cells — deepens response and prolongs PFS in transplant-eligible patients (typically <70 years). Remains the standard of care in first remission for eligible patients despite the daratumumab era.
MRD (measurable residual disease)
IMWG/FDAThe detection of residual myeloma cells at high sensitivity (≥10⁻⁵ — 1 myeloma cell per 100,000 bone marrow cells) by next-generation sequencing or flow cytometry. MRD negativity is the deepest response level — strongly correlated with prolonged PFS and OS. An emerging regulatory endpoint.

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About this hub. Produced by the GMJ News Editorial Team as a public-good service. Every statistic is linked to its primary source. Documents are preserved in the GMJ Repository with full attribution. Georgian Medical Journal · Contact the editorial team
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