Response to treatment

The aim of treatment is to control the myeloma and its effects on the body. To find out how you respond to treatment, several tests will be carried out on a regular basis. Whilst on treatment this usually happens before the start of a new treatment cycle.

These tests may vary from patient to patient, but generally include routine blood and urine testing and occasionally X-rays or scans.

The signs that treatment is working include:

• A fall in paraprotein or free light chain levels
• Less bone pain
• Improvement in anaemia and other

One of the best indicators of response to treatment is an improvement in your general health.

You may hear your doctor refer to your response to treatment by the following categories:

Stringent complete response (sCR) – complete response plus normal free light chain ratio and an absence of myeloma cells in the bone marrow.

Complete response (CR) – less than 5% of plasma cells in the bone marrow and no detectable paraprotein.

Very good partial response (VGPR) – 90% or greater reduction in blood and urinary paraprotein.

Partial response (PR) – Greater or equal to 50% reduction of paraprotein in blood and greater or equal to 90% reduction in 24 hr urinary paraprotein.

Stable disease (SD) – Not meeting the criteria for any of the above.

Progressive disease (PD) – Blood and urinary paraprotein levels increase by 25% from baseline.

A small number of patients fall into the progressive myeloma category i.e. the treatment has had no effect whatsoever on the myeloma, and are said to be primary refractory. If this is the case, an alternative treatment combination will be sought.

 Side-effects of initial treatment