MRD negativity within 6 months of diagnosis increases likelihood of MRD conversion and relapse in MM patients. Forest plots (A-B) of the relative risk for (A) patients with MRD conversion to experience the given clinical end point. Patients with MRD conversion were confirmed to be more likely to have disease progression relative to patients with sustained MRD negativity, particularly for clinical relapse. (B) Patients with attainment of MRD negativity up to 6 months from treatment have a greater risk of MRD conversion or clinical relapse relative to patients with first MRD negativity detected >6 months. (C) Patients that achieved MRD negativity up to 6 months from treatment have a more rapid time to MRD conversion from initial MM diagnosis (HR, 65.5; 95% CI, 26.7-163.0; P < .0001). (D) Forest plot of the RR for patients with clinical relapse are more likely to experience an IMWG-defined relapse using a cutoff of >0.20 ratio of myeloma to normal plasma cells. Number of patients represents the total number of patients with the given clinical end point. Upper and lower bars represent 95% CI.