The University of Miami is a private nonprofit institution located in south Florida. Sylvester Comprehensive Cancer Center (Sylvester) is the only academic-based cancer center in south Florida and serves as a regional hub for cancer-related research, diagnosis and treatment. Multiple myeloma is a cancer of the blood, attacking plasma cells found in bone marrow. This year, an estimated 35,000 adults in the US will be diagnosed with the disease and 12,500 deaths are expected. As with other cancers, early detection is the key to understanding how the disease develops. This grant provides support for a major research initiative that leverages the power of genome sequencing to further understand how myeloma progresses in some patients with early-stage disease, while others escape full blown myeloma. The ultimate goal of the study is to further the discovery of a curative approach to myeloma by treating earlier, with less toxic therapy and with advanced monitoring to rule out minimal residual disease.