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Figure 1. Presently, multiple myeloma patients are prognosticated based on R-ISS criteria which do not account for molecular complexity and thus cannot accurately discriminate between risk groups. Moreover, R-ISS categories do not inform treatment protocols. Molecular prognostication via gene expression profiling provides superior risk-stratification, accurately distinguishing truly high-risk (HR) patients from standard-risk (SR). This, in turn, can inform treatment protocols, directing SR patients towards less-intensive therapies and HR towards more personalised multi-drug approaches based on their individual genetic sensitivity profiles. Created with BioRender.com. R-ISS: Revised international staging system.