From episodic assessment to comprehensive assessment: integrating real-world monitoring in relapsed/refractory multiple myeloma

INTRODUCTION: Patients with relapsed/refractory multiple myeloma (RRMM) now receive sequential lines of therapy over many years, generating cumulative toxicities, functional decline, and symptom burden that conventional trial endpoints and episodic clinic-based monitoring fail to capture. A synthesis of contemporary real-world monitoring strategies in RRMM is therefore needed to guide clinical practice. AREAS COVERED: This review examines real-world monitoring strategies for RRMM, encompassing patient-reported outcome (PRO) instruments, real-world data (RWD) sources (electronic health records, claims, registries, patient-driven platforms), and digital health technologies enabling continuous between-visit assessment. Literature was identified through structured searches of PubMed and MEDLINE from January 2000 through April 2026, supplemented by manual review of reference lists and abstracts from major hematology meetings. We evaluate how these strategies complement conventional disease assessment, inform treatment sequencing in the era of CAR T-cell therapies and bispecific antibodies, and address equity gaps in monitoring access. EXPERT OPINION: Integrating PROs, RWD, and digital health tools into routine RRMM care is a necessary evolution toward continuous, personalized disease management; coordinated investment in interoperable data infrastructure, rigorous real-world evidence frameworks, and equity-conscious implementation will be essential to translate these strategies into improved survival and quality of life for all patients.