Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission

Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.

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Multiple Myeloma – Stringent, Complete, Very Good Partial

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Achieving a complete remission/response to your induction therapy, according to the study linked below, is the Multiple Myeloma Remission Criteria that the newly diagnosed MM patient cancer achieve…

When the newly diagnosed myeloma patient reaches stringent. complete or very good partial response to treatment, that is great.  Repeated studies document how these three responses will, on average, lead to the longest first remissions and possibly the longest overall survival (length of life).

The challenge is what it takes to get there. And how much toxicity your body will endure.

As early as you can in your therapy plan, ask you oncologist how many newly diagnosed myeloma patient actually achieve stringent or complete remission. If he/she is honest with you, the answer may disappoint you.

If you pursue the extreme version of the conventional, standard-of-care therapy plan, you will undergo an extreme amount of toxicity. Please understand what this means to you over the next few years.

I understand that questioning the purpose of myeloma therapy might sound silly but I’m trying to make a point.

If you are diagnosed with multiple myeloma, stage 1,2 or 3, the first thing your oncologist will tell you is to begin therapy ASAP. And of course, you assume that you are going to undergo chemotherapy (defined as any form of chemical therapy) so you agree to do so.

Your challenge is that you don’t know what you don’t know. And that there may be less toxic therapy plans to get you a long overall survival. As well as a higher quality-of-life!

Multiple Myeloma Remission Criteria:

  • Stringent Complete Response (sCR)
  • Complete Response (CR) Negative immunofixation on the serum and urine and disappearance of any soft tissue plasmacytomas and < 5% plasma cells in bone marrow3-
  • Very Good Partial Response (VGPR)-Serum and urine M-protein detectable by immunofixation but not on electrophoresis or > 90% reduction in serum M-protein plus urine M-protein level < 100 mg/24 h

Decision #1- no brainer

Myeloma induction therapy, usually Revlimid, Velcade, dexamethasone (RVd),  while toxic and will probably cause side effects, is done by the patient because doing nothing, undergoing no therapy, will lead to sickness and death pretty quickly.

Decision #2- ah…maybe… but…

After X number of cycles (3 weeks on, 1 week off, for however many months), the patient reaches some type of remission- in the case of this post, stringent, complete  response/remission. And again, even though the toxic therapy will cause short and long-term health problems, the patient may decide to  undergo more therapy- an autologous stem cell transplant and may even continue toxic therapy with maintenance.

Decision #3- What’s the point?

According to the research study linked below, the point of undergoing therapy and enduring short and long-term side effects is more time. To quote the study below

“”Achievement of a complete response (CR) in multiple myeloma (MM) correlates with improvement in survival outcomes; however, its impact on prognostic variables at baseline outside of clinical trial settings is not well described.”

This study is current aka published in January of 2022. Keep in mind however, that the study was not able to find that complete remission meant a longer life. The study had to go out two years (24 months) of living in complete remission in order to document a longer overall survival.

In other words, those people who reach, and remain in complete remission for two years, will, on average, achieve a longer

  • progression-free survival (by 8 months) and
  • overall survival (by 30 months)

compared to those myeloma patients who do not achieve complete remission.

Two years of aggressive, high dose chemotherapy regimens will get you more time,  on average,  a length of life of 8.6 vs 5.8 years. In other words, if you undergo all that therapy and if you do well and maintain complete remission all that time, you will live, on average, 2.2 years longer than newly diagnosed myeloma patients who undergo the standard-of-care therapy plan, induction, ASCT, maintenance but who don’t reach stringent or complete remission.

You’ve got to ask yourself:

  • Is there a better way?
  • Is there a less toxic way?
  • Will you undergo aggressive therapies yet not make it anyway?

Please don’t misunderstand me. I think reaching MRD, sCR or CR is a worthwhile goal for the newly diagnosed myeloma patient. I am simply pointing out that there may very well be a better way of reaching both a long overall survival AND a high quality-of-life.

I’ve studied and written about stringent complete response and complete response for years now.

Learn more about your prognosis as a myeloma patient- click now

Have you been diagnosed with multiple myeloma? What were your symptoms? What therapies are you considering?

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Impact of achieving a complete response to initial therapy of multiple myeloma and predictors of subsequent outcome

“Achievement of a complete response (CR) in multiple myeloma (MM) correlates with improvement in survival outcomes; however, its impact on prognostic variables at baseline outside of clinical trial settings is not well described.

We sought to determine the impact of achieving a CR within 2 years from diagnosis, its effect on the prognostic value of fluorescence in situ hybridization (FISH) and International Staging System (ISS) risk, and examined additional predictors of outcome among those achieving a CR in a routine clinical setting.

We evaluated 1869 newly diagnosed MM patients who had ≥ 2 monoclonal protein immunofixation studies in the serum and urine available within 24 months from diagnosis, categorizing those with ≥ 2 negative serum and urine immunofixations as achieving CR.

With a landmark at 24 months, median progression-free survival (PFS) for CR versus non-CR patients was 29.8 versus 20.9 months (p ≤ .0002); median overall survival (OS) was 104 versus 70 months (p < .0001).

The impact of achieving a CR was retained after adjusting for FISH, ISS, sex, transplant status, and involved heavy chain.

Baseline FISH and ISS stage were not associated with PFS or OS among patients achieving a CR.

The following variables were found as predictors of inferior OS within the CR cohort:

  • age > 75 years,
  • male gender,
  • hypoalbuminemia,
  • and non-immunoglobulin G involved heavy chain.

Our study confirms that achievement of CR within 2 years from diagnosis is associated with improvement in survival outcomes and neutralization of the impact of FISH and ISS risk, thereby confirming observations from the clinical trial setting among a clinical practice cohort…”

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