CD38-based therapy has become a backbone therapy across all lines,1 but, more patients will be refractory to these drugs at early lines and management of relapsed/refractory multiple myeloma (RRMM) that is refractory to anti-CD38 therapies is challenging despite the increasing number of new options (antibody-drug conjugated antibodies, bispecific antibodies2 and CAR-T cell therapies3–5). This evidence concerns the gene CD38 and AL amyloidosis.