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What Does Remission Mean in Myeloma?

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Published on March 4, 2020

Key Takeaways

  • Remission means that there is no detectable disease but does not necessarily mean a patient is cured.

Multiple myeloma expert Dr. Frits van Rhee, from the University of Arkansas for Medical Sciences Myeloma Center, answers a patient’s questions about what remission really means. Watch as Dr. van Rhee explains different levels of remission, tests used to determine response, and how outcomes for those living with myeloma are improving.

This program is sponsored by GSK. This organization has no editorial control. It is produced by Patient Power. Patient Power is solely responsible for program content.

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Transcript | What Does Remission Mean in Myeloma?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:                       

Bill wrote in this question, Dr. van Rhee, “I was told I’m in remission, but my light chain numbers are going up, and the lambda is low; what does that mean? And does “remission” mean I do not have the disease?”

Dr. van Rhee:                

Remission means that there is no detectable disease, so there are different levels of remission. And when we talk about “complete remission,” they mean that the bone marrow looks normal under the microscope, and there is no myeloma protein or free light chain levels detectable, and the latter not being above the limit of normal because we all have some light chains circulating. 

Then, the second category is optical astringently defined complete remission, where the minimal residual disease test is negative. So, minimal residual disease test seeks out very low numbers of myeloma cells, remaining in a normal-looking bone marrow under the microscope, and there are two different tests for that presently being used; one is called flow cytometry, and one is a molecular test called next-generation sequencing

Andrew Schorr:                       

Mm-hmm, okay. So, if somebody’s told they’re in remission, though, unfortunately, it doesn’t mean they’re cured.

Dr. van Rhee:                

Well, we will only know with very long-term follow-up, where patients are being cured, and one of the unique things at our center is that we do have very long-term follow-up on our patients, on some trials in excess of 15 years. We do try to capture everybody lifelong. And there is a group of patients in the order of 20 percent who actually never relapsed, even with very prolonged follow-up. I think the exciting thing is that with the currently available novel drugs, that we can deepen the responses, and we can give novel drugs both during induction as consultation after transplant and as maintenance therapy. And hopefully, the cure—the magical cure will be within reach for more patients in the future.

Andrew Schorr:                      

I hope so. Some of the folks on the Internet know a very active advocate who works with Patient Power, Jack Aiello. And so, Jack is like 23 years out from treatment with Dr. Barlogie earlier at your institution so many years ago. And while he had some side effects from the treatment, some neuropathy, Jack is doing great, and we’re like 23 maybe 24 years out, so that’s great news.

Dr. van Rhee:                

So, I think in that sense, it’s a time of great excitement, and there are a lot of novel therapies being developed. And I think we need to learn how best to apply them, how to individualize therapy, but I think the outcomes of myeloma are already improving, and will be further improved in the future.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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