The diagnosis and treatment of multiple myeloma (MM) are progressing 
continuously. This article aims at summarizing the current status in the 
diagnosis and treatment of MM, emphasizing a clinical point of view. Prognostic 
factors can be determined by clinical parameters, molecular analyses and patient 
characteristics (e.g. age and comorbidities). The international staging system 
(ISS) and cytogenetics, such as the high-risk aberrations 17p deletion, 
translocation (4;14) and insertion 1q21 > 2 copies, are key factors in risk 
stratification of MM patients. Induction therapy based on novel agents, namely 
bortezomib, followed by subsequent high-dose melphalan and autologous stem cell 
transplantation is considered the standard of care for younger, newly diagnosed 
MM patients (≤ 70 years). Transplant-ineligible patients should receive 
thalidomide or bortezomib-based chemotherapy. The combination of bortezomib, 
melphalan and prednisone (VMP) was shown to significantly improve overall 
survival (OS) compared to melphalan and prednisone (MP, 56.4 vs. 43.1 months, 
p = < 0.01). Recent results suggest that lenalidomide-based therapy not 
incorporating alkylating agents might be a competitive alternative with a 
favorable toxicity profile for transplant-ineligible patients. Maintenance 
therapies are of increasing clinical significance in MM as they have the ability 
to prolong overall survival; however, thalidomide maintenance therapy should not 
be used in MM patients with high-risk cytogenetics as it shortens OS. Refractory 
or relapsed MM treatment continues to improve with the development of second and 
third generation immunomodulatory agents and proteasome inhibitors. For example, 
pomalidomide and dexamethasone vs. high-dose dexamethasone significantly 
improved OS (12.7 vs. 8.1 months, p = 0.03). Novel therapy strategies include 
targeted and stroma-directed approaches. Antibodies targeting CS-1 (elotuzumab) 
and CD38 (daratumumab) in particular are currently undergoing advanced clinical 
phase II/III trials.