For multiple myeloma therapies (proteasome inhibitors and immunomodulatory agents), the HFA-ICOS table uses therapy-specific risk factors grouped as Medium¹ (1 point), Medium² (2 points), High, and Very High. Risk categories are assigned as follows: Low = no risk factor or one Medium¹ factor; Medium = 2–4 medium points; High = ≥5 medium points or any High factor; Very High = any Very High factor.

The multiple-myeloma-specific factors include very-high-risk items such as heart failure/cardiomyopathy, prior proteasome inhibitor cardiotoxicity, venous thrombosis, cardiac amyloidosis, and arterial vascular disease; high-risk items such as prior immunomodulatory drug cardiovascular toxicity, elevated BNP/NT-proBNP, age ≥75 years, baseline LVEF <50%, and prior anthracycline exposure; plus medium factors such as borderline LVEF 50–54%, arrhythmia, LVH, elevated troponin, age 65–74, hypertension, diabetes, hyperlipidaemia, CKD, family history of thrombophilia, prior thoracic spine radiotherapy, high-dose dexamethasone, smoking history, and obesity.