Efforts to predict disease progression in SMM have led to the development of integrated genetic models. Notably, the IMWG 2020 model sought to incorporate genetic data, including fluorescence in situ hybridization (FISH) results, such as t(4;14), t(14;16), +1q, del(13p), and monosomy 13[16]. However, current risk stratification models still struggle to capture the full spectrum of SMM progression, as even patients categorized as low to intermediate risk can experience disease progression.