A novel genomic risk assessment tool, the MM-like score, has been developed to predict progression risk in multiple myeloma (MM).Multiple myeloma is a blood cancer that often starts with asymptomatic phases like monoclonal gammopathy and smoldering myeloma.The MM-like score uses whole-genome sequencing data to track the evolution of MM from early stages to malignancy.It provides a dynamic risk estimation based on genetic mutations, surpassing traditional clinical parameters.Study highlights the importance of genomic insights in predicting disease progression and individualized treatment planning.Genomic data analysis from over 1,000 patients revealed genetic alterations occurring years before clinical diagnosis.The MM-like score correlates with disease advancement and could serve as a biomarker for real-time monitoring and risk prediction.Future goals include making the MM-like score available as a non-invasive liquid biopsy for more accessible disease monitoring.This innovative approach could lead to early therapeutic interventions and improved outcomes for high-risk patients.Deep whole-genome sequencing has allowed for the detection of crucial genetic events, reshaping understanding of multiple myeloma evolution.