Living with Myeloma

What Is The Difference Between Relapsed and Refractory Myeloma

As with most cancers, and really anything medical, there are a lot of multiple myeloma terms and vocabulary out there that you might not know from the beginning. Getting to know the definition of multiple myeloma terms will help with understanding information about the disease.

What Is Relapsed Multiple Myeloma?

It is often said that there is no cure for multiple myeloma, but it is treatable. At first, this can be confusing. An easy analogy is diabetes. Certain types of diabetes are incurable, but the person can live a normal life with regular insulin injections.

With multiple myeloma the problem is that no matter what treatment you use and not matter how well it works, chance are myeloma will come back at some time in the future. This is what relapsed myeloma means.

Relapsed myeloma means that multiple myeloma has returned. For example, I am currently MRD negative, which means that there is no detectable myeloma in my blood. When (if) my myeloma returns, we say that I have relapsed.

What Is Refractory Multiple Myeloma?

Refractory myeloma means that the myeloma stopped responding or does not respond to a particular treatment. For example, if a patient with multiple myeloma is taking Revlimid and that is working to keep their myeloma number low, but then the patient’s myeloma stops responding to Revlimid, then their myeloma is refractory to Revlimid. It is unlikely the body will ever respond to Revlimid again.

This is where the lines of multiple myeloma treatment comes in. If a patient has done one kind of treatment, but then needs to switch to another, then that is two lines of treatment. The lines of multiple myeloma treatment are important because they determine which treatments a patient can use. Some drugs, or trials are only approved for patients who have already undergone four lines of treatment, or whatever.

Other treatments like CAR-T are approved for relapsed/refractory myeloma, which basically means it can’t be the first treatment a patient tries.

About the Author

Brian is an expert on having multiple myeloma via first-hand knowledge as a patient but is not a doctor. Brian was diagnosed with multiple myeloma in 2019. He has been living with it ever since. All information is for informational purposes only and is not medical advice. Check with your own doctor about your specific situation for medical advice.

Multiple Myeloma

Myeloma Drug Glossary Dictionary

This is one of those things that I’m going to put into a nice graphic when I have the time. For now, hopefully this table proves useful as a thesaurus of myeloma drugs, and their brand names vs generic drug names.

Myelo – A prefix meaning marrow or of the spine

Myeloma – a tumor of plasma cells, usually in the bone marrow or spine

Multiple Myeloma – same as myeloma – since myeloma technically means ONE tumor of plasma cells, multiple myeloma relays that there are usually more than one tumor of plasma cells

dexamethasone – steroid commonly used in treatment of myeloma. Used both to interfere with fast growing cells (cancer cells) and to reduce or block allergic reactions to other treatments – this is why you can’t sleep

Selinexor – treatment drug that blocks cellular export of proteins involved in cancer-cell growth (newish – approved 2019) – Approved to be used with bortezomib and dexamethasone (in place of Revlimid)

Revlimid – brand name for lenalidomide – part of the RVd (Revlimid, Velcade, dexamthasone standard induction treatment cocktail) – This is why you have fatigue.

Velcade – brand name for bortezomib – the V in RVd – this is why your hands and/or feet hurt (neuropathy) also fatigue

induction or induction therapy – the first in a series of treatments, like being inducted into the club, only the club sucks, it’s a cancer club. For multiple myeloma patients, induction is usually taking chemotherapy pills for a while with the goal of reducing (eliminating) the amount of cancer in the body and reduce (eliminate) tumors caused by multiple myeloma. Induction therapy comes before stem cell transplant (ASCT) if your treatment includes a transplant.

ASCT – autologous stem cell transplant – a stem cell transplant that uses your own stem cells (as opposed to getting stem cells from a donor) – usually a treatment for those under 70 and in good health

melphalan – the drug they give you at the beginning of ASCT that destroys your immune system – may be used as an ongoing treatment at a much lower dosage