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Myeloma Relapse not a Relapse?!
When is a myeloma relapse not a relapse? No, this is not a dad joke. I’m serious. Just because a MM patient’s number (s) increase does not mean they have to rush to begin a different treatment. A relapse is not a “clinical relapse” if it is a “biochemical relapse.”
Do not be surprised if your oncologist wants to begin treatment as soon as one or more of a MM survivor’s blood work changes. This change could be one value.
I’m not saying that you should not begin a different treatment regimen. I’m simply saying that chemo cocktails can be exhausting. Even damaging to the patient. MM patients and caregivers frequently are looking for the best time for a break or therapy vacation.
I’m saying that a biochemical relapse could be the time to give the MM patient a therapy vacation. Without sacrificing too much. And gaining time to let your body heal, perhaps letting your blood levels- red, white blood cells, and platelets- return to normal.
Biochemical Relapse of Multiple Myeloma
As always, ask your oncologist if you are experiencing a biochemical relapse and not a clinical relapse. And then ask your oncologist if you could take a therapy vacation until you reach a clinical relapse.
The treatment of MM has come a long way since my diagnosis in early 1994. I don’t think diagnostic testing was sensitive enough back then to distinguish between biochemical and clinical relapses.
Email me at David.PeopleBeatingCancer@gmail.com to learn more about managing your MM with both conventional and non-conventional MM therapies.
Thank you,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
The median time for a biochemical relapse (BR) in multiple myeloma (MM) to progress to a clinical relapse (CR) is approximately 5 months.
However, the duration of BR can vary significantly; some patients may progress to CR within months, while about 20-25% of patients may remain in biochemical relapse for several years without progressing to symptomatic disease.
Factors influencing the duration of biochemical relapse
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Individual variability:
Each patient’s disease biology and response to treatment are unique, leading to a wide range of times to progression.
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Disease characteristics:
Factors like the presence of high-risk genetic abnormalities at diagnosis can influence the pattern and aggressiveness of relapse.
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Treatment strategies:
The timing of treatment initiation following a biochemical relapse is a subject of ongoing research, with some studies suggesting benefits to starting treatment earlier rather than waiting for clinical symptoms to develop.
Implications for treatment decisions
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Delayed treatment:
Historically, the aim was to delay treatment until clinical relapse to spare patients from early side effects, as early rescue options were limited.
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Early treatment approaches:
Recent evidence suggests that initiating treatment after a biochemical relapse, rather than waiting for a clinical relapse, may improve patient outcomes.
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Close monitoring:Continued monitoring of M protein levels is crucial to detect biochemical relapse and make informed decisions about when to start treatment.myeloma relapse not a relapse myeloma relapse not a relapse myeloma relapse not a relapse