Most people living with multiple myeloma will go through periods of relapse and remission. The type of treatment doctors recommend can depend on your past treatment, side effects, and other factors.

Multiple myeloma is a cancer of a certain type of mature white blood cell called plasma cells. These cells play an important part in the immune system. Multiple myeloma occurs when these cells grow out of control.

When this happens, harmful chemicals can build up in the body. This can lead to concerns including low blood counts, kidney issues, more frequent infections, and bone and calcium problems.

While multiple myeloma doesn’t have a cure, up to 90 percent of people with multiple myeloma respond well to treatment and can have an extended period of time where the cancer symptoms improve, known as remission. When multiple myeloma symptoms worsens after a period of remission, this is a relapse.

Read on for answers to some frequently asked questions about a multiple myeloma relapse.

According to the International Myeloma Foundation, you experience a relapse of multiple myeloma when signs or symptoms of the disease come back following a period of remission. A relapse can occur at any time after you have gone through treatment.

In some cases, you may notice symptoms returning on your own. However, not all the indicators that suggest a relapse will be easily observable without testing. Your doctor should monitor your blood work regularly to help check for a relapse. They may also suggest additional testing, like urinalysis or bone evaluations.

Though clinical guidelines exist, your doctor may determine that you’re experiencing a relapse based on your specific symptoms and medical history. Everyone responds to multiple myeloma differently, which means that your doctor can be a valuable resource in determining whether you’re experiencing a relapse and how to treat it.

Relapse times can vary between people. They can depend on a variety of factors, including how well someone responds to treatment and what their overall health status aside from myeloma is.

In some cases, a person could relapse within 12 months, while in other cases, they might not relapse for a significantly longer period of time.

In a 2016 study of 511 patients, researchers found that the average time to relapse was about 26 months. Those whose relapse occurred within 12 months of initial treatment often had a worse prognosis and survival rate than those who experienced a longer period of remission.

The study noted that people who relapsed within 12 months had an average survival rate of around 23 months, while those who relapsed later had an average survival rate of around 122 months. The researchers suggested that people with an earlier relapse should be targeted for enrollment in clinical trials.

According to a 2019 study, median 5-year survival rates have increased steadily in the last several decades. This is due primarily to new treatments. Researchers indicate that the current 5-year survival rate is currently around 50 percent, up from 25 percent in the 1970s.

Tests may not detect all cancer cells in the body. Treatments aren’t always able to destroy all the cells either. This means that the likelihood of experiencing a relapse of multiple myeloma is high.

The International Myeloma Foundation indicates that most people living with multiple myeloma will go through periods of relapse and remission. They indicate that a person may have a period of response to treatment that lasts 2 to 3 years or longer. Other research suggests the initial remission period may last 4 years or more.

According to a 2016 study, your doctor should carefully examine the effectiveness of your previous treatment and any ill effects experienced from them. Evaluating your past treatments and monitoring your current condition will help determine the best time to start therapy for you.

They should base the decision on:

  • prior responsiveness to therapies
  • your overall health
  • medications you’ve used in the past
  • prior adverse effects you’ve experienced
  • your expectations
  • how well you tolerate treatment

According to the International Myeloma Foundation, treatment following a relapse often depends on the initial therapy used and when the relapse occurred.

For example, if you had an autologous stem cell transplant (ASCT) that resulted in 2 to 3 years of remission, your doctor will likely recommend a second transplant.

If you used non-transplant therapies and have a relapse within 6 months to a year, they’ll likely also recommend reusing the same therapy initially used to achieve remission. Your odds of another remission using the same therapy are about 50 percent.

Research from 2017 states that due to the recurring nature of the condition, doctors should consider a broader picture from the start of treating the condition. Researchers indicate that a systematic approach to treatment that accounts for treatment options for the duration of the disease can help improve your overall outcomes.

Multiple myeloma is a cancer that affects a specific type of white blood cell. While there’s currently no cure, newer treatments are leading to longer periods of remission between relapses.

If you or a loved one has multiple myeloma and experience a relapse, there are still treatment options available to help you achieve another period of remission and maintain a good quality of life.