Treatment of multiple myeloma (MM) has improved greatly over the past few years; however, certain patients remain at high risk of rapid relapse, either because of general background traits, or because their disease has a genetic tendency to proliferate quickly and aggressively. Here, Martin Kaiser, MD, RWTH, of the Royal Marsden NHS Foundation Trust, London, UK, spoke to us at the British Society for Haematology (BSH) 2018 Annual Meeting in Liverpool, UK, about how high risk MM can be identified genetically so that treatment plans can be adapted. Dr Kaiser also discusses the Myeloma UK (MUK) Nine b: OPTIMUM study (NCT03188172), which aims to integrate genetic screening into treatment planning so that patients can receive more targeted, effective care.