The incidence of multiple myeloma (MM) increases with age. According to foreign literature, the median age of MM diagnosis is 70 years, 35% of patients are younger than 65 years, 28% are 65 to 74 years, and 37% are 75 years or older. With the increase in life expectancy of the population, the number of elderly patients increases and the number of MM cases increases every year. Principles of treatment for elderly MM In the treatment of asymptomatic MM, there is no evidence to suggest that early intervention provides benefit to the patient. Treatment should be initiated immediately for symptomatic MM. Symptomatic MM is often associated with end-stage organ damage (CRAB): C: hypercalcemia (>11.5 mg/dl); R: renal failure (serum creatinine >1.73 mmol/L); A: anemia (hemoglobin 2 g/dl but below the lower limit of normal); B: bone disease (osteolytic lesions, severe bone loss and pathological fractures). Indications for retreatment of relapsed MM are MM disease progression with CRAB; treatment is also required if there is no CRAB but M protein doubles within 2 months. Since patients older than 65 years are no longer eligible for transplantation, 65 years is used as the cut-off point for MM autologous stem cell transplantation. However, the physiological age often does not correspond to the actual age. Reduced intensity autologous transplantation (Marfalan 100 mg/m2, Mel100) should be considered for patients in excellent clinical condition. Full-dose chemotherapy is recommended for patients between the ages of 65 and 75 years, while reduced-dose chemotherapy should be used appropriately for patients over 75 years of age or in younger patients with severe complications (severe cardiac, pulmonary, renal or hepatic dysfunction). Treatment should be stopped immediately in the event of a serious adverse reaction (grade 4 or higher hematologic toxicity or grade 3 or higher non-hematologic toxicity). Treatment should be restarted at an appropriately reduced dose when serious adverse reactions resolve or drop below grade 1. Whether prognostic factors should be considered in the treatment of elderly MM remains controversial. MM is classified into 3 stages using the International Staging System (ISS). patients with abnormal FLC ratios in each ISS stage have a correspondingly increased risk stratification. among cytogenetic abnormalities detected by FISH, although del13 combined with del17 or t(4;14) is associated with poor prognosis, the occurrence of del13 alone does not suggest poor prognosis. del17 or t(4;14) or t(14;16) detected by FISH 14) or t(14;16) had a poor prognosis, while t(11;14) did not suggest a poor prognosis, and hyperdiploidy was associated with a better prognosis.