CR or VGPR Makes NO Difference in Newly Diagnosed Multiple Myeloma

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Complete Response (CR) or Very Good Partial Response (VGPR) In Newly Diagnosed Multiple Myeloma Makes NO Difference in Overall Survival. None. 

It would be logical to think that a complete response or MDR status translated into a long overall survival. I know I thought this when I had my autologous stem cell transplant. According to the two studies linked and excerpted below, I was wrong to think this.

Click the image below-

Multiple Myeloma Mind Map

Please don’t misunderstand me. Yes, a complete response is a positive indicator for a long overall-survival. But the opposite is not true. Not achieving a CR does not mean that you will not live a long OS. I had my autologous stem cell transplant in 12/95, relapsed about a year later and here I am writing this blog post 22 plus years later.

Or as Dr. Rajkumar (MM specialist) put it:

“It is one thing to say that achievement of complete response is a prognostic marker, but quite another to take that to mean we need to treat patients until they reach complete response.”

22 plus years of surviving MM and coaching MM patients had taught me that the key to living a long-overall survival in MM is to use the best of both conventional FDA approved MM and combine it with the best of non-conventional, evidence-based MM therapies to manage your MM. It is not about CR, VGPR or MDR.

It is about quality of life (QOL) and overall survival (OS).

Have you been diagnosed with multiple myeloma? If so, what stage? What symptoms are you experiencing? Bone pain? Anemia? Kidney damage?

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

Thank you,

David Emerson

  • Long-term MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

No Association Between Response Rates and Survival in Newly Diagnosed Multiple Myeloma

“There was no association between conventional response outcomes, such as complete response (CR) or very good partial response (VGPR), and survival in patients with newly diagnosed multiple myeloma, according to the results of a meta-regression analysis published recently in the European Journal of Hematology…

“We explored the relationship between response to initial treatment and survival in patients with newly diagnosed multiple myeloma, based on data from 63 randomized clinical trials”…

Meta-regression analyses failed to demonstrate any association between CR or (CR or VGPR) with either overall survival or progression-free survival both in patients receiving autologous stem cell transplant [ASCT] and in non-ASCT patients.”

Should Myeloma Patients Panic If They Do Not Achieve A Complete Response?

“Of course, the cause of my worry is not that patients have not achieved the magical complete re­sponse or minimal residual disease-negative status, but at how mis­in­ter­pre­ta­tion of data can lead to needless concern, unnecessary chemo­ther­a­py, increased side effects and cost of care, and even harm

Multiple myeloma is a remarkably heterogeneous disease; the outcomes vary dramatically depending on the patient’s chromosomal abnormalities. The type of myeloma one patient has may be completely different than the myeloma another patient has; it may not even be the same disease….”


David Emerson is a 23 year Multiple Myeloma survivor. He started as a non-profit in 2004 to help cancer survivors and caregivers navigate the vast world of cancer issues by providing evidence-based information on the most pressing cancer issues. Since 2004, David has impacted over 600,000 people through this website. He is in the process of developing cancer-specific coaching program, and also does one-on-one coaching via phone or email. Thank you for visiting!

Posted in Multiple Myeloma, Newly Diagnosed Tagged with:
4 comments on “CR or VGPR Makes NO Difference in Newly Diagnosed Multiple Myeloma
  1. steve says:

    M protein level was over 500 and now is 15 after 3 cycles and before ASCT and continue with treatments.
    I’m deferring ASCT. thoughts?

    • David says:

      Hi Steve-

      According to the study linked in the blog post that you came in on your overall survival (OS) does not depend on reaching complete remission after your induction therapy. Further, according to studies the timing of an ASCT also makes no difference to your OS. So you should be fine when you defer your ASCT.

      As a MM survivor myself who lives with several long-term and late stage side effects from my induction therapy and ASCT I firmly believe that toxicity must be managed carefully. See how your body handles the toxicity of your induction therapy. Are you experiencing any side effect such as PN?

      Having said the above I will go on to say that I think your M-spike should continue to fall if you undergo another cycle of induction therapy. Do you intend to have one or more cycles of induction therapy?

      What was your stage when you were first diagnosed? How are you feeling in general?

      David Emerson

  2. Alie sjonger says:

    Ik heet Alie ben 15 juni 61 jaar 6 jaar terug keer ik te horen dat ik smeulende multipel mylenom had vorige jaar werden twee kleine plekjes op mijn schedel gevonden .nu in november weer een vr scan en bloedprikken .

    • David says:

      Hi Alie-

      I don’t speak your language however I used “google translate” to translate your comment as follows-

      “My name is Alie on June 15, 61 years 6 years back, I heard I had smoldering multiple mylenom last year, two small spots on my skull were found. In November again, a fresh scan and bloodstains.”

      Based on the above words, I do not see any question of yours. What do you want to know? What is your m-spike? Have you been given a stage of myeloma? SMM is considered to be “pre-MM” not full blown MM.

      thanks and hang in there,

      David Emerson

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