The three Rs: Remission, Relapse, Refractory
Myeloma is what is known as a relapsing-remitting cancerA term for diseases in which malignant cells divide without control. Cancer cells can invade nearby tissues and spread through the bloodstream and lymphatic system to other parts of the body.. That means it alternates between periods of:
Remission: stable diseaseThis describes patients who have some response to treatment but <50% reduction in myeloma protein levels. Stable disease is not necessarily bad or sub-optimal (as compared to CR or PR) provided the myeloma has stabilized and is not progressing. With slow moving myeloma, stabilization can last for many years. that is controlled by treatment
Relapse: symptoms and/or complications that need to be treated
Refractory: When myeloma does not respond to treatment
What does remission mean?
Remission is the complete or partial disappearance of the signs and symptoms of myeloma.
It can be classified three ways:
complete remission
partial remission
very good partial remission
When reading about multiple myeloma — and more particularly about research — you’re likely to come across terms like “complete response” (CR) or “partial response” (PR). Please be aware that different studies may apply different definitions to the same terms.
Unfortunately, despite achieving a complete response, the vast majority of patients relapseThe reappearance of signs and symptoms of a disease after a period of improvement. because of the persistence of residual myeloma cells — so-called minimal residual disease (MRD). MRD is the term used to describe the myeloma cells that remain in the bone marrowSpongy tissue that is found inside your bones. It is soft, fatty and full of blood vessels. Your bone marrow is where most of the blood cells in your body are made. after treatment. They are present at such low levels that they cannot be detected by traditional blood or bone marrow testing.
MRD is potentially a very important measurement to determine exactly how well treatment has worked. However, more sensitive and standardized tests are needed before it can become a routine clinicalInvolving direct observation of a patient. measurement.
| Response category acronyms used by the International Myeloma Working Group | |
|---|---|
| sCR | stringent Complete Response |
| CR | Complete Response |
| VGPR | Very Good Partial Response |
| PR | Partial Response |
| SD | Stable Disease |
| PD | Progressive DiseaseDisease that is becoming worse, as documented by tests. |
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Learn more about the role of maintenance therapyChemotherapy that is given to patients in remission to delay or prevent a relapse. in prolonging remission after a stem cellThe basic unit of any living organism. transplant in this Myeloma Canada InfoVideo.
You may feel better during remission than you have in a while.
Eating well, getting exercise, taking care of your emotional health, learning to relax, and coping with the effects and the stress associated with illness are important to maintaining wellness.