NCCN Guidelines for Patients™: Multiple Myeloma
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The treatment response is defined by how well
systemic therapy is killing myeloma cells and the
severity of side effects. The treatment response will
fall into one of the six groups listed below. “Complete”
and “partial” responses are often jointly referred to as
• Complete response
No M-protein in the blood or urine, less than 5
out of 100 blood cells in the bone marrow are
plasma cells, and no increase in the size and
number of bone lesions.
• Partial response
The amount of M-protein in the blood has
decreased by half or more, there’s at least a 90%
drop of M-proteins in the urine, and no increase
in size or number of bone lesions.
• Stable disease
Cancer tests show no signs of response and no
signs of decline.
• Progressive disease
At least a 25% increase in levels of M-protein in
the blood and urine, 25% increase in the number
of plasma cells in the bone marrow, increase in
size or number of bone lesions, or increase in
calcium levels not explained by other conditions.
• Clinical relapse
Direct signs of cancer growth; signs of organ
damage; increase in the number or size (at least
50% larger) of plasmacytomas or bone lesions;
increased calcium levels; increase in creatine
levels in blood; or a decrease in the number of
red blood cells.
• Relapse from complete response
A return of M-proteins in blood or urine, 5 or
more out of 100 blood cells in the bone marrow
are plasma cells, there are new or enlarging
bone lesions, or there are high calcium levels
not explained by other conditions.
Measuring treatment response