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Myriad prognostic factors have been identified and incorporated into risk stratification models; however, these produce discordant, often three\u2010tiered outputs that fail to identify many patients destined for ER. Treatment strategies are increasingly focused on disease biology and trials enriched for high\u2010risk (HR)MM, but consensus on the minimum required testing and a succinct, specific, and clinically meaningful definition for HRMM remains elusive. 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