It is not unusual for myeloma patients to live 10 years or more. Outcomes are influenced by patient factors, such as stage of the disease, chromosome changes, age, and other medical problems. Patients should discuss individual potential outcomes with their doctors.
Click here to access myeloma survival statistics.
Measuring Treatment Response
Your doctor must monitor your response to treatment for myeloma. By measuring your progress, your doctor can see whether any changes to your therapy are needed.
Your doctor uses the following tests to measure your treatment response:
- Bone imaging studies, such as x-ray studies, MRI and PET scans
- Blood and urine tests to check blood cell counts, kidney function and myeloma-cell growth
- Bone marrow aspiration and biopsy to observe the pattern and amount of myeloma cells in the marrow
Treatment response, as determined by these well-established methods, is often supplemented with measurements of minimal residual disease (MRD). A number of techniques can be used to identify MRD, including
- Immunophenotyping by flow cytometry of a bone marrow aspirate. Immunophenotyping uses antibodies to look for specific proteins on the surface of cells that are unique to each cell type, allowing for identification or fingerprinting of those cells. It can help, for example, in determining whether plasma cells in the marrow are from left over myeloma, or if they are normal plasma cells.
- Polymerase chain reaction (PCR) using allele-specific oligonucleotide probes (ASO-PCR), usually on bone marrow. This is a method to make many copies by PCR of the abnormal regions of plasma cells to be able to better detect even small amounts of remaining myeloma.
- Next-generation sequencing (NGS) of either the bone marrow or blood.
Your doctor may use one of the following terms in the table below to describe your response based on your test results.
|Term Used to Describe Response||Characteristics|
No sign of the disease.
|Complete response||Standard tests show no sign of M protein, a normal percentage of plasma cells (5 percent in the marrow) or no sign of myeloma cells in the marrow.|
|Near complete response||Above normal free light chains ratio and no myeloma cells detected in the marrow by very sensitive tests.|
|Very good partial response||A 90 percent or greater decrease in M protein but not meeting the definition for a complete response.|
|Partial response||More than a 50 percent decrease in M protein in the blood and a 90 percent reduction in M protein in 24-hour urine collection but not meeting the definition for a complete or very good partial response.|
|Minimal response||Reduction between 25 percent and 50 percent in M protein in the blood.|
|Stable disease||Less than a 25 percent decrease or less than a 25 percent increase in M protein in the blood.|
|Progressive disease||At least a 25 percent increase in M protein in the blood and if associated with symptoms, usually indicates the need to start therapy or to change therapies if the patient is already receiving treatment.|