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Selected standard risk patients can delay transplant until first relapse. Frail patients who are not candidates for transplant are treated with a triplet regimen, either anti\u2010CD 38 antibody plus lenalidomide and dexamethasone, or VRd.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Maintenance Therapy<\/jats:title>\n                    <jats:p>Standard maintenance is lenalidomide in combination with daratumumab or isatuximab. Lenalidomide is discontinued after 2\u2009years in standard\u2010risk patients. Bortezomib plus lenalidomide is an alternative option for high\u2010risk myeloma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Management of Relapsed Disease<\/jats:title>\n                    <jats:p>Major options are chimeric antigen receptor T (CAR\u2010T) cell therapy, bispecific antibodies, various triplet regimens, and belantamab mafadotin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Management of Smoldering Multiple Myeloma<\/jats:title>\n                    <jats:p>Daratumumab for 3\u2009years should be considered in high\u2010risk smoldering multiple myeloma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ajh.70475","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:58:46Z","timestamp":1787115526000},"page":"2866-2889","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multiple Myeloma: 2026 Update on Diagnosis, Risk\u2010Stratification and Management"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5862-1833","authenticated-orcid":false,"given":"S. Vincent","family":"Rajkumar","sequence":"first","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota 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