What Is Active Myeloma?

In most cases, active  is least complicated biologically and is easiest to treat early in the disease course. The amount of protein ( ) secreted by myeloma cells is lowest when the disease is still asymptomatic, in the and smoldering myeloma phase.

As the disease progresses, the myeloma cells grow in number, resulting in higher levels of protein. When biomarkers show that  either already is, or will soon become symptomatic, treatment is initiated.

What Are First Line Treatments in Myeloma?

The first line of treatment is also called "induction" or "frontline" therapy. In killing myeloma cells, therapy reduces the amount of protein and halts further medical problems related to . Current frontline combination therapy usually produces a deep and durable or " ," during which time the production of protein levels off or "plateaus."

What Are the Types of in Myeloma?

Remissions are categorized as follows:

  • In a complete ( ), protein is no longer detectable.
  • A very good partial (VGPR) indicates at least a 90% drop in protein.
  • A partial (PR) indicates at least a 50% drop in protein.
  • Minimal (MR) indicates a drop in protein of at least 25%.
  • Stable disease (SD) means that the level of protein neither decreased nor increased.

Remissions are often maintained for long periods of time with continuous or "maintenance" therapy. But because myeloma is a remitting and relapsing disease, in most cases the myeloma cells that have resisted prior therapy will begin to grow again in time, protein levels will once again increase, and a will occur. 

How Do You Monitor Your Myeloma on an Ongoing Basis?

Your doctor will order various tests and monitor your results closely in order to treat you at the appropriate time — not too soon, but before you experience medical problems related to your . Treatment is started with a new regimen, or with one that worked well for you as induction therapy. In most, but not all cases, the to treatment for this first is shorter, and may not be as deep, as the to was.

There are many treatment options for successive relapses. Most patients do well for long periods of time — many live for decades after diagnosis — but in most cases, responses become shorter and less deep with each subsequent , and the disease eventually becomes refractory — unresponsive — to available treatments.

What's Next?

The Durie-Salmon Staging System demonstrates the correlation between the amount of myeloma and the damage it has caused, such as bone disease or anemia.


The International Myeloma Foundation medical and editorial content team

Comprised of leading medical researchers, , oncologists, oncology-certified nurses, medical editors, and medical journalists, our team has extensive knowledge of the treatment and care landscape. Additionally, Dr. Brian G.M. Durie reviews and approves all medical content on this website.

Last Medical Review: August 1, 2019

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