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MM SCIENCE
COMMONLY USED TERMS
THE LANGUAGE OF MM

With so much complex language surrounding multiple myeloma (MM), it’s difficult to know what all of it might mean. You and your healthcare team might be using different terms to say the same thing, or you may want to know what a specific word means.

Let’s define some common MM terms
What does response mean?

Response determines how well a treatment is working by measuring the amount of M-protein in your blood and urine, as well as how many MM cells are present in your bone marrow. Response can also be measured by reductions in the size of any visible tumors. There are different levels that assess how deep a response is. For instance, a complete response means there are no detectable M-proteins in your body, tests show less than 5% of plasma cells in your bone marrow, and all other signs of the cancer have disappeared.

Your doctor might say: 

You’ve responded to treatment, which means your treatment is working. Your doctor may also say that your M-protein count is low, can’t be detected, or is “where it’s supposed to be at this point in treatment.”

What does remission mean?

Complete remission (sometimes referred to simply as remission) means there is no evidence of MM cells present in your body.

Your doctor might say: 

You are currently in remission, but they may also say that you show minimal residual disease, or MRD. It’s important to note that while remission is great news, it does not mean your MM is cured.

What does relapse mean? Relapse in MM occurs when a person who has been treated and responded to therapy begins to show signs the disease is returning. Inside your body, it means your MM cells are increasing again after treatment.
You may have heard of the CRAB or SLiM CRAB criteria before when you were diagnosed with MM. However, this set of measurements can also be used to see if someone has relapsed. 
Any one of the below measurements, including an increase in M-protein, indicates that your MM is active:
  • Calcium: An increase in the calcium levels in your blood that are above normal 
  • Renal: An increase in creatinine, a waste product that muscles produce
  • Anemia: A decrease in hemoglobin, a protein in the blood that carries oxygen
  • Bone lesions: An increase in the size or number of existing bone tumors or bone lesions
  • Other laboratory/diagnostic tests can also show relapse (increase in plasma cells, increase in certain proteins in the blood called free light chains, MRI results)

Your doctor might say: 

  • Your MM is progressing
  • Your M-protein and other lab results aren’t where they should be

They may also tell you it’s time to consider a new treatment to attack your MM.

What does refractory mean? 

Refractory is when your disease doesn’t respond to a particular treatment. Inside your body, it means your MM cells have built up a resistance and can keep growing despite ongoing treatment.

Your doctor might say: 

Your treatment isn’t working the way they had planned or you’re not responding. At this point, you’ll start talking about the next steps. They may suggest trying a different type of treatment.

The difference between relapsed and refractory

These 2 terms are similar, but they mean different things. HealthTree University—a site with hundreds of videos from top MM experts—provides a helpful explanation to break down the differences.

Learn even more terms

Whether you’re living with or caring for someone with MM, knowing the language around this disease can help you feel more confident in talking with your healthcare team about your specific situation and treatment plan. 

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Let's recap
  • Response, remission, relapse, and refractory all mean different things, which can be confusing 
  • Understanding the language around MM can help you feel more confident talking about it with others, including your healthcare team
  • Visit HealthTree University for a 5-minute video that explains the difference between relapse and refractory
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