Mass Accumulation Rate (MAR) as a Predictive Biomarker in Multiple Myeloma

Inclusion Criteria:

1. Written Informed Consent provided by patient

2. MM, with the following conditions:

(CLOSED) For patients in the Vanguard cohort

1. Treatment naïve disease with BM clinically indicated

For patients in the RRMM cohort

1. Relapsed/refractory disease with BM samples clinically indicated

2. Within 4-weeks prior to initiation of 2nd-line or later therapy

3. Patient's oncologist must be planning to change the patient's next line of treatmentto a monotherapy or combination therapy composed exclusively of drugs from thefollowing list: Bortezomib (Velcade), Carfilzomib (Kyprolis), Lenalidomide (Revlimid), Pomalidomide (Pomalyst), Cyclophosphamide (Cytoxan), Dexamethasone,Ixazomib (Ninlaro), Venetoclax (Venclexta), Selinexor (Xpovio)

Exclusion Criteria:

1. Unable or unwilling to provide informed consent

2. Daratumumab/Elotuzumab or other antibody-based therapeutic regimens as immediatelyplanned treatment (as prior therapy is acceptable)

3. Patient enrolled/enrolling in a clinical trial where data or specimen sharingprovisions preclude use in this study

4. Prior exposure to CAR-T therapy

5. Prior allogeneic stem cell transplant

6. Has received any systemic chemotherapy or RT, including palliative, within 7 daysprior to BM biopsy

7. Has received any Ab therapy within 4 weeks prior to BM biopsy