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Prognosis for Multiple Myeloma- Learn from your Multiple Myeloma diagnostic criteria to inform your therapy plan – stage,  CRAB symptoms, risk of progression…

Diagnosing multiple myeloma is notoriously difficult- many people live with bone or nerve pain for months before they are formally diagnosed with multiple myeloma. Because the average age of the newly diagnosed multiple myeloma patient is 70 according to research, myeloma is considered to be a cancer of the elderly.

Like all cancers, the earlier you diagnose myeloma, the better your prognosis will be. Be sure to learn Multiple Myeloma – Signs and Symptoms in order to identify possible symptoms of either pre-myeloma or full multiple myeloma.

The most important thing to remember about multiple myeloma diagnostic criteria is that oncology continues to learn more about our incurable blood cancer and therefore improve their ability to diagnose multiple myeloma at the correct stage to determine your risk of progression.

An example of this is the multiple myeloma diagnostic criteria called SLiM CRAB.

Conventional oncology has taken the basic multiple myeloma diagnostic criteria of-

And added risk of progression by determining that newly diagnosed myeloma patients with:

  • 60% or more clonal plasma cells in the bone marrow were likely to progress and are considered symptomatic,
  • those with light chain ratios of greater than 100 were likely to progress and required treatment at diagnosis, and
  • those with more than 1 focal lesion on MRI likely required systemic therapy as they have transitioned from smoldering myeloma to symptomatic disease.

I think it is helpful to think about some of the big picture issues so I have written about the larger issues the come with a diagnosis of multiple myeloma.

Please read the “Treatment of Multiple Myeloma: Cure vs. Control” linked below. If you understand your diagnostic criteria, you will be able to apply the ideas discussed in the cure vs. control article and therefore understand your therapy plan to treat your multiple myeloma.

Controlling MM combined with evidence-based complementary and integrative therapies I believe, allows the best prognosis for your multiple myeloma.

Do you understand your results? It’s normal to have a lot of questions — or to be confused about where to start.

Get a full understanding of your Multiple Myeloma diagnosis and discover your options.

Scroll down the page, post a question or comment and I will reply to you ASAP.

Hang in there,


To learn more about your multiple myeloma prognosis click now

Learn about my long-term myeloma survivor experience- click now 

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

Treatment of Myeloma: Cure vs Control

“Although not often openly acknowledged, “cure vs control” is the dominant philosophical difference behind many of the strategies, trials, and debates related to the management of myeloma. Should we treat patients with myeloma with multidrug, multitransplant combinations with the goal of potentially curing a subset of patients, recognizing that the risk of adverse events and effect on quality of life will be substantial? Or should we address myeloma as a chronic incurable condition with the goal of disease control, using the least toxic regimens, emphasizing a balance between efficacy and quality of life, and reserving more aggressive therapy for later?

To be sure, if cure were known to be possible (with a reasonable probability) in myeloma, it would undoubtedly be the preferred therapeutic goal of most patients and physicians. But this is not the case. Myeloma is generally not considered a curable disease…

Cure vs control is debated because the strategies currently being tested are not truly curative but rather are intended to maximize response rates in the hope that they will translate into an operational cure for a subset of patients…

In the 1990s, high-dose therapy with autologous stem cell transplant (ASCT) became part of standard practice when it was found to prolong survival compared with conventional chemotherapy.57Subsequently, bisphosphonates were found to be effective in decreasing the incidence of bone lesions.8,9

In fact, it is not uncommon to find that well-meaning investigators interpret the same clinical trial data in opposite ways because they ascribe to different philosophies (cure vs control).19 Although this commentary focuses on myeloma, the cure-vs-control debate may be relevant to other similar chronic malignant and nonmalignant disorders.2028″

Expert Reviews New Diagnostic and Staging Criteria in Multiple Myeloma

“IMWG initially added 3 new biomarkers, among other modifications, to the previously established criteria, which have become known as CRAB, which features elevated calcium levels (C), renal failure (R), anemia (A), and bone lesions (B)…

The new and current diagnostic and staging criteria, known as SLiM CRAB, now include the following: 60% or more clonal plasma cells (S), light chains (Li), and MRI (M).

It has been observed that patients with:

  • 60% or more clonal plasma cells in the bone marrow were likely to progress and are considered symptomatic,
  • those with light chain ratios of greater than 100 were likely to progress and required treatment at diagnosis, and
  • those with more than 1 focal lesion on MRI likely required systemic therapy as they have transitioned from smoldering myeloma to symptomatic disease.

Articles That Discuss Multiple Myeloma Diagnostic Criteria

“Oh no, I’m MRD-positive!,” What Now?

“In the (MM) patients who have been treated with or without transplant but achieve MRD-negative status and CR , when they looked at their survival curves, they were very comparable, not statistically

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What is Stage 3 Multiple Myeloma?

What is stage 3 Multiple Myeloma? What qualifies as stage 3 MM? What are the symptoms of stage 3 MM? How worried should I be if I’ve been diagnosed with stage 3 multiple myeloma? Hi David- Within

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Cancer-Therapy-induced Cardiomyopathy and Your Genes

“The increased burden of rare variants including TTNtv, indicate that genetics are an important component in Cancer-Therapy-induced Cardiomyopathy (CCM) susceptibility and adverse outcomes” I

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Sentinel Lymph Node Biopsy- Breast Cancer:

The researchers conclude "the long-term breast cancer-related event-free survival in the (sentinel node-based dissection) arm was similar to that in the (routine dissection) arm, enabling us to affirm

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Mammography Under 40 Does More Harm Than Good?

This article concludes that "young women have received screening mammography, but few cancers have been detected, regardless of their specific age, race, or other individual characteristics. With

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Multiple Myeloma Staging- CTC

“Evaluation of CTCs in PB outperformed quantification of BM PCs. The detection of ≥ 0.01% CTCs could be a new risk factor in novel multiple myeloma staging systems for patients with transplant-eligible

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Myeloma Staging- High-Risk, Co-Morbidities…

“Current prognostic markers mainly estimate OS, but are limited in their ability to establish the best treatment strategy and to predict the response duration to specific therapies…” Why

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Myeloma, Kidney Damage, Anemia-

Kidney failure in multiple myeloma is a complicated process that involves different processes and mechanisms…”One in four patients treated with cisplatin develop chronic kidney disease… Multiple

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Magnesium- Dementia

“In a study of more than 9,500 men and women, the highest or lowest levels of magnesium appeared to increase the chances for dementia by as much as 30 percent” It’s easy for researchers

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Multiple Myeloma Diagnostics- FISH, SPEP, CBC, FLC’s and Imaging

If you have multiple myeloma your plasma cells produce unhealthy antibodies called monoclonal proteins (M proteins). The accumulation of M proteins in your body can damage organs like your kidneys and

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Multiple Myeloma- Vitamin D3

“Vitamin D deficiency is associated with reduced overall survival for patients with multiple myeloma (MM)…Vitamin D deficiency is increasingly recognized in association with autoimmune and

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Genetic Abnormalities – Myeloma, FISH, Response

“Cytogenetic abnormalities are found in most multiple myeloma (MM) patients. Although their prognostic value has been well studied, there are limited data on the association of primary cytogenetic

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