Fast Five Quiz: Relapsed/Refractory Multiple Myeloma

Maria-Victoria Mateos, MD


January 11, 2022

Figure 1. Normal bone marrow (left) and bone marrow in multiple myeloma (right). The different distribution of cell types, including lymphocytes, platelets, plasma cells, and red blood cells, can be seen.

Relapsed/refractory multiple myeloma is disease that progresses on salvage therapy or within 60 days of the last treatment in patients who in the past experienced at least a minimal response to treatment. Primary refractory multiple myeloma, however, is disease that fails to achieve at least a minimal response with any therapy.

Progressive multiple myeloma is defined as a 25% increase from baseline in serum M protein (absolute increase > 0.5 g/dL), urine M protein (absolute increase ≥ 200 mg/d); percentage of bone marrow plasma cells (absolute percentage increase ≥ 10%); and/or the difference between involved and uninvolved free light chain levels (absolute increase ≥ 10 mg/dL). Progressive disease may also be noted upon development of definite new bone lesions and/or soft-tissue plasmacytomas (with a clear increase in the size of existing plasmacytomas), or hypercalcemia that cannot be attributed to another cause.

Learn more about multiple myeloma.


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