Fast Five Quiz: Relapsed/Refractory Multiple Myeloma

Maria-Victoria Mateos, MD


January 11, 2022

Treatment for relapsed multiple myeloma is indicated when patients develop either symptomatic relapse, a rapidly rising paraprotein level, or extramedullary disease. In other cases, a rapidly increasing monoclonal peak (ie, doubling in 3 months or less) would suggest that treatment should be initiated. Patients experiencing biological relapse alone do not always need to be treated immediately.

In the case of asymptomatic biochemical relapse and a slow rise in the paraprotein level, it may be appropriate to restage the patient's disease and take a rigorous wait-and-watch approach, following up at least every 3 months.

Oligoclonal reconstitution after autologous stem cell transplantation (ASCT) can occur in up to 37% of patients in this setting, but this is temporary and does not indicate relapse.

Learn more about treatment of multiple myeloma.


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