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No cures exist for multiple myeloma, but the latest advances in treatments and research into the disease offer hope to those affected. Researchers have uncovered treatments that have increased remission rates, extended life expectancy, and even improved quality of life for multiple myeloma patients.

Multiple Myeloma (MM) is a cancer of the plasma cells. These white blood cells help produce antibodies. Atypical plasma cells accumulate in the bone marrow, leading to decreased production of healthy red and white blood cells. 

Although survival rates have improved, many patients who achieve complete responses (CRs) to treatment still experience disease progression in the long run. Treating MM has been difficult due to its smoldering (asymptomatic) nature until the introduction of Minimal Residual Disease (MRD).

Related: Predictive Modeling of Multiple Myeloma from Precursor Conditions

The Impact of Minimal Residual Disease on Multiple Myeloma

Compared to more traditional markers like CR or sustained CR, MRD is a more dependable prognostic indicator. MRD positivity is a stronger predictor of disease progression than traditional CR and can be more accurately detected. Due to this discovery, the International Myeloma Working Group (IMWG) believes MM can be considered a curable disease.

IMWG Response Criteria

The IMWG has created response criteria to monitor the progression of MM. It is based on an analysis of response criteria and MRD data collected from clinical trials and includes four categories:

  • No evidence of MM
  • Patient is no longer in treatment
  • Patient has few or no other medical conditions besides those discussed
  • Individuals’ morality is similar to that of people of the same age
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Determining A Patient’s MM Status

The researchers emphasized the importance of maintaining a negative MRD status, achieved by having two consecutive negative MRD test results at least one year apart. Oncologists use positron emission tomography, computed tomography, or multiparameter flow cytometry to detect MRD in the marrow

Researchers have discovered that patients who continued to test negative for MRD had a greater chance of surviving without their disease progressing. It makes testing negative for MRD the most crucial factor in determining a patient’s MM status. 

a man in a white shirt working in a laboratory

Future MM Management

Using MRD to predict patient outcomes has improved MM management tremendously. It helps to identify patients who can benefit from continued treatment and those who may be able to stop therapy if their MRD tests remain negative. Every patient experiences MM differently. Therefore, MRD increases positive patient outcomes. 

It opens the door to individualized treatment and management, which is critical to achieving the best possible outcomes for MM patients. Continued research into treatments for MM and the use of MRD testing is essential in finding new ways to improve patient outcomes.

Looking to understand how imaging can help bridge the gap between MM disease progression and treatment types? Check out the Relationship Between Multiple Myeloma Spatio-Temporal Evolution, Treatment Type, and Relapse post for more information. 

Patient Response to MRD

Researchers believe using MRD will cause up to 40 percent of patients to respond to treatment exceptionally. One study that aimed to understand the impact of MRD on MM proved that almost 60 percent of patients experienced a reduced risk of progression and over 40 percent decreased risk of death. 

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Exceptional responders or patients that have not experienced death or disease progression over the last eight years after their first treatment have the highest disease control rate.

MRD lets patients know their MM status. It gives them a sense of relief knowing that they are receiving the best possible care and treatment. In addition, they can stop or reduce their treatments based on the results of the MRD test, allowing them to reduce the financial burdens and side effects associated with treatment.

Not knowing causes fear and anxiety. However, MRD offers insight into a patient’s MM status and can help to alleviate those fears. It gives patients the confidence to maintain their treatment and take the necessary steps to manage their disease.

Related: Socioeconomic Status Affects Multiple Myeloma Outcomes

MRD Doesn’t Replace Other Response Assessments

Physicians can use MRD alongside other response assessments. It can facilitate informed decisions on treatment options. For example, a patient presents with side effects such as fatigue, nausea, or vomiting. A physician can use the results of MRD to determine whether to continue with treatment.

It can also work in understanding disparities in the treatment of myeloma. For example, only six percent of participants in MM trials are African American. At the same time, Hispanic Americans have higher disease incidents of MM, with the risk of severe renal dysfunction at the time of diagnosis. 

MRD helps to identify better treatment options for those patients who do not have access to clinical trials or other treatments. Doctors who understand MRD’s effects on patient outcomes can adjust their approach and ensure everyone receives the best possible care.

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Related: Distinct Genetic Expression in Rapidly Progressing Multiple Myeloma

a woman meeting with a doctor

Expanding the Positive Impact of MRD

MRD testing has been one of the most effective MM treatment and management breakthroughs, as it allows for personalized care for each patient. MRD is a powerful tool and an essential addition to MM’s arsenal of response assessments. It helps doctors make informed treatment decisions and can even lead to a cure for some patients. 

It’s clear that MRD is the way forward in treating MM and improving patient outcomes. The ability to review individual patient data for a more detailed picture of their MM and its progression may further expand MRD’s positive impact. 

Faster detection times, better research, and more effective treatments are on the horizon. It can greatly improve the quality of life for those living with MM, potentially leading to better outcomes and improved survival rates.