{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:23:48Z","timestamp":1787318628255,"version":"build-2736575974"},"reference-count":154,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Portuguese Society of Hematology\u2014Portuguese Group of Multiple Myeloma"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Multiple myeloma is a complex hematologic malignancy characterized by significant biological heterogeneity, a relapsing\u2013remission clinical course, and a continuously evolving therapeutic landscape. Accurate and timely laboratory assessment is central to disease management, supporting diagnosis, risk stratification, evaluation of treatment response, and long-term monitoring. Despite major advances in therapy, a critical need remains for laboratory tools that can detect disease with greater sensitivity, capture spatial and clonal tumor heterogeneity, and reflect the true depth of treatment response beyond conventional serological and bone marrow-based criteria. Recent laboratory innovations have the potential to transform myeloma care by enabling earlier detection, more accurate prognostication, and personalized therapeutic strategies. This review focuses specifically on innovative laboratory technologies for the diagnosis of multiple myeloma and the evaluation of treatment response. Within this scope, we examine the current diagnostic approaches and the role of high-throughput technologies for measurable residual disease assessment. We explore the emerging role of liquid biopsy approaches, including circulating tumor cells, cell-free DNA\/RNA, and mass spectrometry for ultrasensitive detection of monoclonal proteins. We further discuss novel molecular biomarkers and the integration of artificial intelligence and machine learning tools to enhance data interpretation. The innovations reviewed here represent a shift in the contribution of laboratory medicine to myeloma care, offering a more precise, less invasive, and biologically informative framework for targeted and adaptive clinical decisions.<\/jats:p>","DOI":"10.3390\/cancers18081275","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T10:11:04Z","timestamp":1776420664000},"page":"1275","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["How Laboratory Innovations Are Shaping the Future of Multiple Myeloma Care"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7509-9066","authenticated-orcid":false,"given":"Joana","family":"Caetano","sequence":"first","affiliation":[{"name":"Hemato-Oncology Unit, Funda\u00e7\u00e3o Champalimaud, 1400-038 Lisbon, Portugal"},{"name":"NOVA Medical School, NOVA University of Lisbon, 1169-056 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Marta","family":"Pires","sequence":"additional","affiliation":[{"name":"Clinical Pathology Department, Unidade Local de Sa\u00fade Tr\u00e1s-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Costa","sequence":"additional","affiliation":[{"name":"Hemato-Oncology Unit, CUF Hospital Cascais, 2750-663 Cascais, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Bergantim","sequence":"additional","affiliation":[{"name":"Hematology Department, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"Cancer Drug Resistance Group, Institute of Molecular Pathology and Immunology (IPATIMUP), Universidade do Porto, 4200-135 Porto, Portugal"},{"name":"i3S-Institute for Research and Innovation in Health, Universidade do Porto, 4200-135 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Roque","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Unidade Local de Sa\u00fade de Coimbra, 3004-561 Coimbra, Portugal"},{"name":"Physiology Institute, Faculdade de Medicina, Universidade de Coimbra, 1649-023 Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia","family":"Ferraz","sequence":"additional","affiliation":[{"name":"Hematology Department, Unidade Local de Sa\u00fade Tr\u00e1s-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Ros\u00e1rio","family":"Cunha","sequence":"additional","affiliation":[{"name":"Clinical Pathology Department, Unidade Local de Sa\u00fade de Coimbra, 3004-561 Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1018-5139","authenticated-orcid":false,"given":"Niccolo","family":"Bolli","sequence":"additional","affiliation":[{"name":"Hematology Unit, Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi","family":"Puig","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital Universitario de Salamanca, Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL) y Instituto de Biolog\u00eda Molecular y Celular del C\u00e1ncer (IBMCC), Universidad de Salamanca, Consejo Superior de Investigaciones Cient\u00edficas (USAL-CSIC), CIBERONC, 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3978-766X","authenticated-orcid":false,"given":"Cristina","family":"Jo\u00e3o","sequence":"additional","affiliation":[{"name":"Hemato-Oncology Unit, Funda\u00e7\u00e3o Champalimaud, 1400-038 Lisbon, Portugal"},{"name":"NOVA Medical School, NOVA University of Lisbon, 1169-056 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/S0140-6736(21)00135-5","article-title":"Multiple Myeloma","volume":"397","author":"Pawlyn","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1002\/ajh.27422","article-title":"Multiple Myeloma: 2024 Update on Diagnosis, Risk-Stratification, and Management","volume":"99","author":"Rajkumar","year":"2024","journal-title":"Am. 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