What I wish I knew about Multiple Myeloma treatments 25 years later...

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Medicare Covers MRD Test for Multiple Myeloma

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The first and only test authorized by the FDA to detect and monitor minimal residual disease (MRD) in multiple myeloma (MM)…has received coverage for Medicare patients.

I am a multiple myeloma survivor on Medicare. Because MM is an older person’s disease with an average patient age of 67, I think that the  majority of MM patients are also on Medicare. According to the article linked below, Medicare now covers (pays for) MRD testing for Medicare patients.

I never used to think too much about MM diagnostic testing. Frankly, I considered testing to be a commodity. For example, blood and urine testing can be performed by almost any hosptital (I think?).

Yes, there are differences between different types of imaging studies, for example what MRIs show compared to a PET scan but these tests have been around so long and oncology has no problem prescribing them and getting them covered aka paid for.

Minimal Residual Disease testing is a bit different. MRD is new it seems as if MRD status may directly impact a MM patient’s therapy plan. There is reason to believe that if a newly diagnosed MM patient achieved MRD negative status after undergoing his/her induction therapy, that he/she may not benefit from also undergoing an autologous stem cell transplant (ASCT).

If the patient will enjoy, on average, a longer progression-free survival or a longer overall survival, then there is no need for, no benefit to undergoing an expensive procedure that is sure to bring short, long-term and late stage side effects- an ASCT. At least the patient must ask him or herself the question.

The most important issue to a long-term MM survivor like me is if multiple myeloma can be managed once it reaches MRD negative status. Meaning, once a patient’s MM has been beaten down completely enough to reach MRD negative status- one MM cell per 1 million bone marrow cells, can the patient live a normal life and die of old age some time in the distant future?

Once the patient’s MM is only one cancer cell per 1 million bone marrow cells can his/her MM be kept in complete remission with evidence-based, non-conventional, non-toxic therapies?

Have you been diagnosed with multiple myeloma? What therapies are you considering? Scroll down the page, post a question or a comment and I will reply to you ASAP.

Thank you,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:


Diagnostic Test Assessing MRD in Patients With MM and ALL Receives Medicare Coverage

“The first and only test authorized by the FDA to detect and monitor minimal residual disease (MRD) in multiple myeloma (MM) and B-cell acute lymphoblastic leukemia (ALL) has received coverage for Medicare patients. ClonoSEQ, from Adaptive Biotechnologies, received Medicare coverage aligned with the assay’s FDA label and includes assessing MRD at multiple time points throughout therapy.

So far coverage was announced with Palmetto GBA, a Medicare Administrative Contractor that has jurisdiction in Alabama, Georgia, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia.

MRD refers to the number of cancer cells present and can be used to monitor treatment response and help predict patient outcomes. MRD testing can assess disease burden and monitor for remission and detect relapse…

MRD assessment is becoming standard practice for patient management in blood cancers…”

Minimal residual disease predicts superior survival in patients with multiple myeloma: a meta-analysis

“Conclusions and Relevance- MRD-negative status after treatment for newly diagnosed MM is associated with long-term survival. These findings provide quantitative evidence to support the integration of MRD assessment as an endpoint in clinical trials of MM…”

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