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Classified as primary, de novo or secondary, from relapsed\/refractory myeloma, PCL carries worse outcomes than conventional myeloma despite advances. Genomically, PCL demonstrates high\u2010risk abnormalities like del(17p), 1q21 gain\/amplification and overrepresentation of t(11;14), marking a distinct biological subgroup. Contemporary management involves quadruplet induction, early autologous stem cell transplantation in eligible patients, and multi\u2010agent consolidation\/maintenance. Immune effector therapies, especially BCMA\u2010directed CAR\u2010T, show promise for deeper, more durable responses. 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