The current staging system for myeloma is the standard revised international staging system (R-ISS), which is commonly used for assessing the prognostic outcomes in myeloma, which roughly estimates an overall survival (OS) of 9 years in stage I patients and 3.6 years in stage III patients.1 However, this system does not account for important factors such as chromosome 1 abnormalities (gain 1q or deletion 17p) or the additive effects of multiple high-risk cytogenetic abnormalities such as double- and triple-hit myeloma.1 Similarly, other high-risk factors for MM, including circulating plasma cells, presence of extramedullary disease, disease burden, mutation type, chromosomal abnormalities, clinical phenotype, and gene expression profiling scores, are not accounted for and represented in the current staging system.1