Myeloma and response to treatment

Response to myeloma treatment

You will have tests during your treatment to check how well the myeloma is responding to treatment. This is measured by checking your blood or urine (pee) for abnormal immunoglobulins (paraproteins) and light chains made by the myeloma cells.

If these are below certain levels and myeloma cannot be detected, it is called complete response. This is also sometimes called complete remission.

Levels of response to myeloma treatment

The different levels of response include:

complete response (CR) – this means the paraprotein (M protein) cannot be detected in blood or urine tests and there are fewer than 5% plasma cells in the bone marrow
partial response (PR) – this means the paraprotein level is at least 50% lower than it was before treatment
stable disease – this means the paraprotein is at the same level as it was before treatment.

If you have a type of myeloma that does not make paraproteins, such as a Bence Jones myeloma, your doctor can explain how response will be measured.

Relapsed myeloma

Even though many people have a good response to treatment for myeloma, the myeloma usually comes back after a period of time. This is called recurrent or relapsed myeloma. Doctors may then change your treatment or offer further treatment.

If treatment does not control the myeloma, or stops controlling it, the doctors will talk to you about treatments to manage symptoms.

About our information

References

Below is a sample of the sources used in our myeloma information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

National Institute for Health and Care Excellence (NICE). Myeloma: diagnosis and management. NICE guideline [NG35]. Published: 10 February 2016 Last updated: 25 October 2018. Available from: https://www.nice.org.uk/guidance/ng35/chapter/recommendations Accessed: 19/07/22

Jonathan Sive et al., on behalf of the British Society of Haematology. British Journal of Haematology. Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline. Published: 21 March 2021 Available from: https://onlinelibrary.wiley.com/doi/10.1111/bjh.17410 Accessed: 19/07/22

M.A. Dimopoulos et al. Annals of oncology. European Society for Medical Oncology (ESMO). Multiple myeloma: EHA-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Volume 32, ISSUE 3, P309-322, March 01, 2021. Available from: https://www.annalsofoncology.org/article/S0923-7534(20)43169-2/fulltext Accessed: 19/07/22

Reviewers

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

use plain English
explain medical words
use short sentences
use illustrations to explain text
structure the information clearly
make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.