This session examined how multiple myeloma care is evolving within the Kenyan context, bringing together perspectives on diagnostics, treatment advances and system-level delivery.

A central theme was the contrast between rapid global therapeutic progress and the realities of access and infrastructure in low- and middle-income settings. While survival outcomes have improved significantly with the introduction of proteasome inhibitors, immunomodulatory agents and anti-CD38 therapies, translating these gains into routine practice remains uneven.

The discussion highlighted the importance of accurate and timely diagnosis, with a shift from morphology-based approaches towards molecular and cytogenetic risk stratification to guide treatment decisions.

From a clinical perspective, modern management is increasingly risk-adapted, incorporating quadruplet induction regimens, autologous stem cell transplantation and maintenance strategies. Emerging therapies, including CAR-T cells and bispecific antibodies are redefining outcomes in relapsed disease, though access remains limited in many settings.

At a systems level, the AMPATH multiple myeloma program was presented as a model of how coordinated care can be built through partnerships, integrating clinical care, training and research within a learning health system. The approach emphasizes improving access, strengthening diagnostic and treatment infrastructure, and embedding multidisciplinary care pathways to support patients across the disease course.

Across the session, a consistent message emerged: advancing myeloma care requires not only better therapies, but systems capable of delivering them.

Key Takeaways

• Myeloma outcomes are improving with novel and combination therapies.
• Accurate diagnosis and risk stratification are central to management.
• Standard care includes quadruplet induction, ASCT and maintenance therapy.
• CAR-T and bispecific antibodies are reshaping relapsed disease care.
• Sustainable progress depends on access, infrastructure and integrated care models.