MMulti-Immune HR; Multi-Target Immunotherapy for High-Risk Multiple Myeloma

Inclusion Criteria: * Patients must have newly diagnosed active MM requiring treatment. Patients with a previous history of smoldering myeloma will be eligible if there is evidence of PD requiring initiation of treatment. * Patients must be either untreated or have not received more than two months of MM therapy. However, bisphosphonates and localized radiation are allowed. * Patients must have clinical features of high-risk disease, at time of initial diagnosis or initial assessment prior to enrollment, which may include one or more of the following: * High-risk cytogenetic abnormalities, including t(4;14), t(14;16), t(14;20), del17p13, del1p, or gain 1q with del1p by FISH, with a cutoff point of 20% or greater. * Beta-2-microglobulin \>5.5 mg/L with normal kidney function test per the institutional reference. * Presence of extramedullary disease defined as soft tissue plasmacytoma (excluding Paramedullary/Paraskeletal plasmacytoma) * ≥ 3 focal lesions on F18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging * LDH ≥ 360 U/L (Rule out hemolysis and infection; contact Principal Investigator if any doubt.) * Circulating plasma cells ≥5 percent of white blood cells on conventional peripheral blood smear (manual white blood cell differential count) or peripheral blood flow cytometry. * ECOG ≤ 2, unless solely due to symptoms of MM-related bone disease. * Patients must have a platelet count ≥ 50,000/μL and hemoglobin level of ≥7.5 g/dl and absolute ne…