{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:43:24Z","timestamp":1791924204024,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Multiple myeloma (MM) is an incurable blood cancer characterized by clonal bone marrow plasmacytosis, hypercalcemia, renal failure, anemia, and osteolytic bone disease. Approximately 20% of NDMM patients, not predicted to have high\u2010risk disease at diagnosis, progress early, despite optimal induction +\/\u2212 ASCT and lenalidomide maintenance, and are subsequently categorized as functional high\u2010risk (FHR) disease. Standardized risk\u2010stratification models incorporate biomarkers of tumor burden, existence of high\u2010risk cytogenetics, with the presence\/absence of plasma cell leukemia\/extramedullary disease to attribute high\u2010risk at diagnosis; however, depth\/duration of response to novel agent\u2010based induction (NA\u2010IND) as dynamic markers of disease risk have not been defined. However, irrespective of diagnostic risk\u2010stratification, response to NA\u2010IND may be the single most effective method of identifying patients whose FHR biology portends an unacceptably short overall survival (OS). In this EMN consensus statement, we define FHR\u2010MM as disease progression within 18\u2009months of commencement of first\u2010line therapy in the absence of high\u2010risk cytogenetics, discuss the underlying disease biology, and strategies to improve outcomes for these patients.<\/jats:p>","DOI":"10.1002\/ajh.70070","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T06:15:13Z","timestamp":1757484913000},"page":"2320-2332","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["European Myeloma Network Consensus Statement on Functional High\u2010Risk Multiple Myeloma"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6990-8832","authenticated-orcid":false,"given":"Sueh\u2010li","family":"Lim","sequence":"first","affiliation":[{"name":"Australian Centre for Blood Diseases Monash University  Melbourne Australia"},{"name":"Malignant Haematology, Transplantation and Cellular Therapy Services, the Alfred Hospital Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0405-1676","authenticated-orcid":false,"given":"Monika","family":"Engelhardt","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Stem Cell Transplantation, Clinical Cancer Research Group University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5133-1422","authenticated-orcid":false,"given":"Evangelos","family":"Terpos","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Plasma Cell Dyscrasias Unit, Alexandra General Hospital National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Gay","sequence":"additional","affiliation":[{"name":"Myeloma Unit, Division of Hematology, University of Torino Azienda Ospedaliero\u2010Universitaria Citt\u00e0 Della Salute e Della Scienza  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels W. 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J.","family":"Van de Donk","sequence":"additional","affiliation":[{"name":"Department of Hematology, Amsterdam UMC VU University  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman","family":"Einsele","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital W\u00fcrzburg  Wurzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0808-2237","authenticated-orcid":false,"given":"Pieter","family":"Sonneveld","sequence":"additional","affiliation":[{"name":"Erasmus MC Cancer Institute &amp; Erasmus University of Rotterdam  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Kaiser","sequence":"additional","affiliation":[{"name":"The Institute of Cancer Research  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Boccadoro","sequence":"additional","affiliation":[{"name":"European Myeloma Network  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Spencer","sequence":"additional","affiliation":[{"name":"Australian Centre for Blood Diseases Monash University  Melbourne Australia"},{"name":"Malignant Haematology, Transplantation and Cellular Therapy Services, the Alfred Hospital Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"e_1_2_15_2_1","unstructured":"\u201cInternational Myeloma Society Consensus on Genomic Definition of High\u2010Risk Myeloma \u201dJournal of Clinical Oncology In press."},{"issue":"2","key":"e_1_2_15_3_1","article-title":"Impact of Ultra High\u2010Risk Genetics on Real\u2010World Outcomes of Transplant\u2010Eligible Multiple Myeloma Patients","volume":"7","author":"Panopoulou A.","year":"2023","journal-title":"Hema"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2011.204"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2017.179"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-018-0196-8"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023010579"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2019-129431"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2023000443"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2019.10.014"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16793"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.236588"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-20-0951"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2024-193310"},{"issue":"1","key":"e_1_2_15_15_1","first-page":"1687","article-title":"CHARACTERISICS and Outcomes of Patients With Functional High Risk Multiple Myeloma From the HONEUR Federated Data Network","volume":"8","author":"Yael Cohen N. 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