Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Multiple myelomais a rare, incurable cancer of plasma cells that affects 1 in every 132 Americans.It can lead to multi-organ failure, causing a variety of symptoms that range from weakness and fatigue to bone pain andrenal failure.
The prevalence of relapse and drug resistance in people with multiple myeloma is rising. Experts are unsure why, especially since the advent of new, more effective, and less toxic therapies.
People with triple-refractory multiple myeloma have worse overall outcomes than those with multiple myeloma and experience more frequent and persistent symptoms—even after treatment. This underscores the importance of finding new, more effective treatment options.
This article discusses the symptoms, diagnosis, causes, and treatment for triple multiple myeloma.
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Triple-Refractory Multiple Myeloma Symptoms
Multiple myeloma may present with the generalized symptoms of fatigue, weakness, and unexplained weight loss. The symptoms that you experience will depend on the organ system that is affected.
Common symptoms of multiple myeloma include:
The exact cause of multiple myeloma remains a mystery. Some research has pointed to radiation exposure or contact with chemical solvents such as benzene as a possible trigger. Other studies have cited the role of DNA mutations—mistakes or defects in the instructions that give rise to plasma cells—in the development of multiple myeloma.
Recent studies have found that abnormalities ofoncogeneslike MYC and RAS andtumor suppressor geneslike TP53 have been found in myeloma cells in the bone marrow after treatment.
There are multiple causes of drug resistance in triple-resistant multiple myeloma, including:
Despite the introduction of new drugs into treatment regimens, most people with multiple myeloma eventually demonstrate multidrug resistance. This is why it’s so important for science to determine what is causing the resistance.
Finding ways to enhance current therapies while also designing more effective ones is of the utmost importance in cancer research.
Multiple myeloma is a clinical diagnosis that is suspected usually after an adult of about 60 years old or older reports symptoms such as bone pain, fatigue, and kidney problems.
Induction therapy has been shown to slow the progression of multiple myeloma for about 41 months compared to 8.5 months without therapy.
Still, despite the advent of new, more effective, and less toxic therapies, experts have identified people with multiple myeloma who have stopped responding to traditional therapies. This new subset of people with multiple myeloma experience more frequent symptoms—negatively impacting their quality of life—and have poor survival outcomes.
Salvage autologous stem cell transplantation and retrying previous regimens have proven to be effective for a short period of time, but it is clear that the search for new, more effective treatment options is a top research priority.
Your overall outlook depends on the stage of your diagnosis, how your body responds to treatment, and your overall health.
Generally, healthy people who are diagnosed early have a five-year survival rate that is over 75%. The more advanced your stage—that is, the more your cancer has spread—the lower your general prognosis is with those with distant metastases displaying a five-year survival rate of 55%.
The advent of new drugs and the combination of multiple treatment regimens—like conventional chemotherapy and the use of proteasome inhibitors, immunomodulatory agents, and monoclonal antibodies—usually are less effective over time.
Generally, the more resistant you are to conventional therapies, the worse your prognosis. Some research has shown median survival ranges as low as six to nine months for those who relapse or display resistance to two or more treatments.
Summary
Triple refractory multiple myeloma refers to a rare, incurable cancer of plasma cells. It has become more and more resistant to conventional cancer treatments (proteasome inhibitors, immunomodulatory agents, monoclonal antibodies) over time. This has resulted in a lower quality of life and poor survival outcomes for most patients.
A Word From Verywell
The need for newer treatments for multiple myeloma cannot be understated. Clinical trials are vital in helping healthcare professionals and scientists better understand the disease and use this knowledge to develop new treatments.
If you have multiple myeloma, participating in a clinical trial may be a good option for you. If you are interested in such a trial, be sure to speak with a healthcare professional about which clinical trials are available and whether one of them may be right for you.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Cancer facts & figures 2021.Costa LJ, Hungria V, Mohty M, Mateos MV.How I treat triple-class refractory multiple myeloma.Br J Haematol. 2022 Jul;198(2):244-256. doi:10.1111/bjh.18185Podar K, Leleu X.Relapsed/refractory multiple myeloma in 2020/2021 and beyond.Cancers (Basel). 2021 Oct 14;13(20):5154. doi:10.3390/cancers13205154American Cancer Society.What causes multiple myeloma?Pinto V, Bergantim R, Caires HR, Seca H, Guimarães JE, Vasconcelos MH.Multiple myeloma: available therapies and causes of drug resistance.Cancers (Basel). 2020;12(2):407. Published 2020 Feb 10. doi:10.3390/cancers12020407Robak P, Drozdz I, Szemraj J, Robak T.Drug resistance in multiple myeloma.Cancer Treat Rev. 2018;70:199-208. doi:10.1016/j.ctrv.2018.09.001Cowan AJ, Green DJ, Kwok M, et al.Diagnosis and management of multiple myeloma: a review.JAMA. 2022;327(5):464–477. doi:10.1001/jama.2022.0003American Cancer Society.Survival rates for multiple myeloma.Richardson P, Mitsiades C, Schlossman R, et al.The treatment of relapsed and refractory multiple myeloma.Hematology Am Soc Hematol Educ Program. 2007;317-323. doi:10.1182/asheducation-2007.1.317
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Cancer facts & figures 2021.Costa LJ, Hungria V, Mohty M, Mateos MV.How I treat triple-class refractory multiple myeloma.Br J Haematol. 2022 Jul;198(2):244-256. doi:10.1111/bjh.18185Podar K, Leleu X.Relapsed/refractory multiple myeloma in 2020/2021 and beyond.Cancers (Basel). 2021 Oct 14;13(20):5154. doi:10.3390/cancers13205154American Cancer Society.What causes multiple myeloma?Pinto V, Bergantim R, Caires HR, Seca H, Guimarães JE, Vasconcelos MH.Multiple myeloma: available therapies and causes of drug resistance.Cancers (Basel). 2020;12(2):407. Published 2020 Feb 10. doi:10.3390/cancers12020407Robak P, Drozdz I, Szemraj J, Robak T.Drug resistance in multiple myeloma.Cancer Treat Rev. 2018;70:199-208. doi:10.1016/j.ctrv.2018.09.001Cowan AJ, Green DJ, Kwok M, et al.Diagnosis and management of multiple myeloma: a review.JAMA. 2022;327(5):464–477. doi:10.1001/jama.2022.0003American Cancer Society.Survival rates for multiple myeloma.Richardson P, Mitsiades C, Schlossman R, et al.The treatment of relapsed and refractory multiple myeloma.Hematology Am Soc Hematol Educ Program. 2007;317-323. doi:10.1182/asheducation-2007.1.317
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.Cancer facts & figures 2021.Costa LJ, Hungria V, Mohty M, Mateos MV.How I treat triple-class refractory multiple myeloma.Br J Haematol. 2022 Jul;198(2):244-256. doi:10.1111/bjh.18185Podar K, Leleu X.Relapsed/refractory multiple myeloma in 2020/2021 and beyond.Cancers (Basel). 2021 Oct 14;13(20):5154. doi:10.3390/cancers13205154American Cancer Society.What causes multiple myeloma?Pinto V, Bergantim R, Caires HR, Seca H, Guimarães JE, Vasconcelos MH.Multiple myeloma: available therapies and causes of drug resistance.Cancers (Basel). 2020;12(2):407. Published 2020 Feb 10. doi:10.3390/cancers12020407Robak P, Drozdz I, Szemraj J, Robak T.Drug resistance in multiple myeloma.Cancer Treat Rev. 2018;70:199-208. doi:10.1016/j.ctrv.2018.09.001Cowan AJ, Green DJ, Kwok M, et al.Diagnosis and management of multiple myeloma: a review.JAMA. 2022;327(5):464–477. doi:10.1001/jama.2022.0003American Cancer Society.Survival rates for multiple myeloma.Richardson P, Mitsiades C, Schlossman R, et al.The treatment of relapsed and refractory multiple myeloma.Hematology Am Soc Hematol Educ Program. 2007;317-323. doi:10.1182/asheducation-2007.1.317
American Cancer Society.Cancer facts & figures 2021.
Costa LJ, Hungria V, Mohty M, Mateos MV.How I treat triple-class refractory multiple myeloma.Br J Haematol. 2022 Jul;198(2):244-256. doi:10.1111/bjh.18185
Podar K, Leleu X.Relapsed/refractory multiple myeloma in 2020/2021 and beyond.Cancers (Basel). 2021 Oct 14;13(20):5154. doi:10.3390/cancers13205154
American Cancer Society.What causes multiple myeloma?
Pinto V, Bergantim R, Caires HR, Seca H, Guimarães JE, Vasconcelos MH.Multiple myeloma: available therapies and causes of drug resistance.Cancers (Basel). 2020;12(2):407. Published 2020 Feb 10. doi:10.3390/cancers12020407
Robak P, Drozdz I, Szemraj J, Robak T.Drug resistance in multiple myeloma.Cancer Treat Rev. 2018;70:199-208. doi:10.1016/j.ctrv.2018.09.001
Cowan AJ, Green DJ, Kwok M, et al.Diagnosis and management of multiple myeloma: a review.JAMA. 2022;327(5):464–477. doi:10.1001/jama.2022.0003
American Cancer Society.Survival rates for multiple myeloma.
Richardson P, Mitsiades C, Schlossman R, et al.The treatment of relapsed and refractory multiple myeloma.Hematology Am Soc Hematol Educ Program. 2007;317-323. doi:10.1182/asheducation-2007.1.317
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