Malard F, Neri P, Bahlis NJ, Terpos E, Moukalled N, Hungria VTM, et al. Multiple myeloma. Nat Rev Dis Primers. 2024;10:45. https://doi.org/10.1038/s41572-024-00529-7.

Article  PubMed  Google Scholar 

Rajkumar SV. Multiple myeloma: 2024 update on diagnosis, risk-stratification, and management. Am J Hematol. 2024;99:1802–24. https://doi.org/10.1002/ajh.27422.

Article  PubMed  PubMed Central  Google Scholar 

Dimopoulos MA, Terpos E, Boccadoro M, Moreau P, Mateos MV, Zweegman S, et al. EHA-EMN evidence-based guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma. Nat Rev Clin Oncol. 2025;22:680–700. https://doi.org/10.1038/s41571-025-01041-x.

Article  PubMed  Google Scholar 

Avet-Loiseau H, Davies FE, Samur MK, Corre J, D’Agostino M, Kaiser MF, et al. International Myeloma Society/International Myeloma Working Group consensus recommendations on the definition of high-risk multiple myeloma. J Clin Oncol. 2025;43:2739–51. https://doi.org/10.1200/JCO-24-01893.

Article  PubMed  Google Scholar 

Baysal M, Julian K, Sborov D, Godara A, McClune B, Lohr JG, et al. The past, present and future of myeloma staging and risk prognostication. Oncologist. 2025;30:oyaf299. https://doi.org/10.1093/oncolo/oyaf299.

Article  PubMed  PubMed Central  Google Scholar 

Brieghel C, Slordahl TS, Andersen MN, Szabo AG, Niemann CU, Thorsteinsdottir S. A real-world International staging system (RW-ISS) for patients with newly diagnosed multiple myeloma. Blood Cancer J. 2025;15:59. https://doi.org/10.1038/s41408-025-01268-y.

Article  PubMed  PubMed Central  Google Scholar 

D’Agostino M, Cairns DA, Lahuerta JJ, Wester R, Bertsch U, Waage A, et al. Second revision of the International Staging System (R2-ISS) for overall survival in multiple myeloma: a European Myeloma Network (EMN) report within the HARMONY project. J Clin Oncol. 2022;40:3406–18. https://doi.org/10.1200/JCO.21.02614.

Article  PubMed  CAS  Google Scholar 

Mayo Clinic Treatment Guidelines: Multiple Myeloma-mSMART Risk Stratification of Newly Diagnosed Myeloma. https://www.msmart.org/mm-treatment-guidelines. Accessed 2 June 2025.

Fechtner K, Hillengass J, Delorme S, Heiss C, Neben K, Goldschmidt H, et al. Staging monoclonal plasma cell disease: comparison of the Durie-Salmon and the Durie-Salmon PLUS staging systems. Radiology. 2010;257:195–204. https://doi.org/10.1148/radiol.10091809.

Article  PubMed  Google Scholar 

Chen Z, Yang A, Chen A, Dong J, Lin J, Huang C, et al. [68Ga]Pentixafor PET/CT for staging and prognostic assessment of newly diagnosed multiple myeloma: comparison to [18F]FDG PET/CT. Eur J Nucl Med Mol Imaging. 2024;51:1926–36. https://doi.org/10.1007/s00259-024-06621-0.

Article  PubMed  PubMed Central  Google Scholar 

Abe Y, Ikeda S, Kitadate A, Narita K, Kobayashi H, Miura D, et al. Low hexokinase-2 expression-associated false-negative 18F-FDG PET/CT as a potential prognostic predictor in patients with multiple myeloma. Eur J Nucl Med Mol Imaging. 2019;46:1345–50. https://doi.org/10.1007/s00259-019-04312-9.

Article  PubMed  CAS  Google Scholar 

Dammacco F, Rubini G, Ferrari C, Vacca A, Racanelli V. 18F-FDG PET/CT: a review of diagnostic and prognostic features in multiple myeloma and related disorders. Clin Exp Med. 2015;15:1–18. https://doi.org/10.1007/s10238-014-0308-3.

Article  PubMed  CAS  Google Scholar 

Philipp-Abbrederis K, Herrmann K, Knop S, Schottelius M, Eiber M, Luckerath K, et al. In vivo molecular imaging of chemokine receptor CXCR4 expression in patients with advanced multiple myeloma. EMBO Mol Med. 2015;7:477–87. https://doi.org/10.15252/emmm.201404698.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Buck AK, Haug A, Dreher N, Lambertini A, Higuchi T, Lapa C, et al. Imaging of C-X-C Motif Chemokine Receptor 4 Expression in 690 Patients with Solid or Hematologic Neoplasms Using 68Ga-Pentixafor PET. J Nucl Med. 2022;63:1687–92. https://doi.org/10.2967/jnumed.121.263693.

Article  PubMed  CAS  Google Scholar 

Lapa C, Schreder M, Schirbel A, Samnick S, Kortum KM, Herrmann K, et al. [68Ga]pentixafor-PET/CT for imaging of chemokine receptor CXCR4 expression in multiple myeloma - comparison to [18F]FDG and laboratory values. Theranostics. 2017;68(1):205–12. https://doi.org/10.7150/thno.16576.

Article  CAS  Google Scholar 

Chavoshi M, Mirshahvalad SA, Kohan A, Ortega C, Metser U, Farag A, et al. CXCR4-targeted PET imaging in hematologic malignancies: a systematic review and meta-analysis. Clin Nucl Med. 2025;50:e7–16. https://doi.org/10.1097/RLU.0000000000005426.

Article  PubMed  Google Scholar 

Shekhawat AS, Singh B, Malhotra P, Watts A, Basher R, Kaur H, et al. Imaging CXCR4 receptors expression for staging multiple myeloma by using 68Ga-Pentixafor PET/CT: comparison with 18F-FDG PET/CT. Br J Radiol. 2022;95:20211272. https://doi.org/10.1259/bjr.20211272.

Article  PubMed  PubMed Central  Google Scholar 

Kuyumcu S, Isik EG, Tiryaki TO, Has-Simsek D, Sanli Y, Buyukkaya F, et al. Prognostic significance of 68Ga-Pentixafor PET/CT in multiple myeloma recurrence: a comparison to 18F-FDG PET/CT and laboratory results. Ann Nucl Med. 2021;35:1147–56. https://doi.org/10.1007/s12149-021-01652-1.

Article  PubMed  CAS  Google Scholar 

Lu N, Chen L, Yu F, Xiao Z, Xing D, Zhong J, et al. Evaluating the value of chemokine receptor type 4-targeted PET imaging in diagnosing primary aldosteronism lateralization: a comparison with adrenal venous sampling. Surgery. 2025;181:109156. https://doi.org/10.1016/j.surg.2025.109156.

Article  PubMed  Google Scholar 

Pan Q, Cao X, Luo Y, Li J, Feng J, Li F. Chemokine receptor-4 targeted PET/CT with 68Ga-Pentixafor in assessment of newly diagnosed multiple myeloma: comparison to 18F-FDG PET/CT. Eur J Nucl Med Mol Imaging. 2020;47:537–46. https://doi.org/10.1007/s00259-019-04605-z.

Article  PubMed  CAS  Google Scholar 

Nioche C, Orlhac F, Boughdad S, Reuze S, Goya-Outi J, Robert C, et al. LIFEx: a freeware for radiomic feature calculation in multimodality imaging to accelerate advances in the characterization of tumor heterogeneity. Cancer Res. 2018;78:4786–9. https://doi.org/10.1158/0008-5472.CAN-18-0125.

Article  PubMed  CAS  Google Scholar 

Kim DK, Jung JY, Kim H, Lee S, Lee SY, Lee S, et al. Development of a semiquantitative whole-body MRI scoring system for multiple myeloma. Radiology. 2023;308:e230667. https://doi.org/10.1148/radiol.230667.

Article  PubMed  Google Scholar 

Yang Y, Li J, Lei W, Wang H, Ni Y, Liu Y, et al. CXCL12-CXCR4/CXCR7 axis in cancer: from mechanisms to clinical applications. Int J Biol Sci. 2023;19:3341–59. https://doi.org/10.7150/ijbs.82317.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Wang W, Huang M, Tian R, Shen G. Head-to-head comparison of 68Ga-PentixaFor PET/CT and FDG PET/CT for detecting hematologic and solid cancers: a systematic review and meta-analysis. AJR Am J Roentgenol. 2025;225:e2532708. https://doi.org/10.2214/AJR.25.32708.

Article  PubMed  Google Scholar 

Nakamoto-Matsubara R, Nardi V, Horick N, Fukushima T, Han RS, Shome R, et al. Integration of clinical outcomes and molecular features in extramedullary disease in multiple myeloma. Blood Cancer J. 2024;14:224. https://doi.org/10.1038/s41408-024-01190-9.

Article  PubMed  PubMed Central  Google Scholar 

Landgren O, Rajkumar SV. New developments in diagnosis, prognosis, and assessment of response in multiple myeloma. Clin Cancer Res. 2016;22:5428–33. https://doi.org/10.1158/1078-0432.CCR-16-0866.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Yang Q, Zhang F, Hao Z, Zhuang J, Huo L. Chemokine receptor 4-targeted PET/CT with [68Ga]pentixather in newly diagnosed multiple myeloma: a comparative study with [68Ga]pentixafor PET/CT. Mol Imaging Biol. 2024;26:986–94. https://doi.org/10.1007/s11307-024-01953-7.

Article  PubMed  CAS  Google Scholar 

Burger JA, Peled A. CXCR4 antagonists: targeting the microenvironment in leukemia and other cancers. Leukemia. 2009;23:43–52. https://doi.org/10.1038/leu.2008.299.

Article  PubMed  CAS  Google Scholar 

Ito S, Sato T, Maeta T. Role and therapeutic targeting of SDF-1α/CXCR4 axis in multiple myeloma. Cancers (Basel). 2021;13:1793. https://doi.org/10.3390/cancers13081