It’s possible to live for many years following a relapse of multiple myeloma. Your outlook depends on a number of factors, including the length of time since your last relapse and which treatments you have tried.

Multiple myeloma is a type of blood cancer that forms in plasma cells, which are found in the spongy material inside bones called bone marrow. Mutated plasma cells can multiply rapidly and crowd out healthy cells in the bone marrow.

There’s currently no cure for multiple myeloma, but the cancer can go into remission with treatment. However, if the signs and symptoms of your cancer reappear later, it’s then considered relapsed.

Relapse is common with multiple myeloma. Many people with multiple myeloma experience several periods of remission, followed by relapse.

This article will discuss the life expectancy for people with multiple myeloma after relapse.

According to the National Cancer Institute (NCI)’s SEER database, the 5-year relative survival rate for multiple myeloma is 61.1%. A 5-year relative survival rate indicates the likelihood of surviving 5 years after diagnosis compared to similar people who don’t have multiple myeloma.

Keep in mind that the NCI relies on past data to estimate survival rates. In another retrospective study published in 2020, which included 300 people with multiple myeloma after the first relapse, the median overall survival was 44.8 months after the first relapse.

In general, the earlier the relapse, the worse the outlook. As time goes on, the cancer also changes and becomes more complex. Each subsequent relapse can be more difficult to treat. However, your life expectancy depends on many factors, such as:

  • your age and current health
  • the length of your remission before relapse
  • how many times you’ve had a relapse
  • how well you responded to the initial treatment
  • how early your cancer was diagnosed
  • the genetics of your cancer
  • if you had any severe side effects to treatment
  • how well do you tolerate the new treatment

Research also shows survival rates have been increasing over recent years due to advances in treatment.

A relapse is also known as a recurrence. Generally, it means that the signs and symptoms of your cancer have returned after a period of improvement.

Once you enter remission, your doctor will monitor your blood work regularly to check for signs of a relapse.

Your doctor will determine whether you’ve relapsed using the results of blood tests and imaging, as well as a physical exam and an evaluation of your symptoms.

You may not always experience symptoms if you have a relapse. If you do have symptoms, they may include:

  • bone pain
  • fatigue
  • kidney problems
  • anemia
  • high calcium levels
  • increased chance of bleeding
  • breathlessness

These symptoms may be more severe than when the cancer was first diagnosed.

To officially diagnose a relapse, doctors will rely on the results of various imaging, urine, and blood tests to see whether you meet the criteria from the International Myeloma Working Group.

According to the International Myeloma Foundation, an early relapse refers to the first, second, or third time the myeloma progresses after a period of remission. Later relapse (fourth, fifth, and beyond) means that multiple lines of therapy have already been tried. You may eventually reach a stage where everything has been tried.

At this point, your cancer may be considered refractory. Refractory means your cancer is no longer responding to treatment.

It’s important to meet with a doctor, such as a hematologist or oncologist, to evaluate your treatment options. Treatment for relapsed myeloma is highly individualized and based on many factors.

Treatment options may include chemotherapy, corticosteroids, and other classes of drugs, such as monoclonal antibodies. Some people may undergo an autologous stem cell transplant

If your remission lasted several years, your doctor may recommend reusing the therapy that brought about your remission.

For example, if you were in remission for at least 2 to 3 years after receiving an autologous stem cell transplant, a second transplant at relapse may be an option for you.

Another option is to add another medication or combination of medications to your initial treatment. For later relapses, your doctor may recommend trying an entirely new regimen.

How long can you live with multiple myeloma without treatment?

While multiple myeloma can be treated, it’s rarely curable. Before chemotherapy was available, patients had a median survival rate of only 7 months.

Can you live 10 years with multiple myeloma?

With the introduction of chemotherapy, the outlook has greatly improved and the median survival rate is now between 24 to 30 months, according to a study from 2020. Still, the overall 10-year survival rate remains low at only 3%.

What are the criteria for a multiple myeloma relapse?

The International Myeloma Working Group (IMWG) has criteria that help doctors determine if your multiple myeloma has relapsed. These are:

  • increase in plasmacytomas (plasma cell tumors)
  • hypercalcemia (excess calcium)
  • decrease in the protein hemoglobin
  • rise in a waste product called creatinine
  • hyperviscosity (blood thickening)
  • increase in myeloma proteins (M-protein) levels by at least 25% or an increase of >10 mg/dL in free light chain levels (which can suggest a problem with your plasma blood cells)

What is the end stage of multiple myeloma?

The final stage, also known as stage 3 or the distant stage, is when the cancer has spread beyond its original location. With treatment, those with advanced multiple myeloma have a 57% chance of living for at least 5 years compared to those without it.

How many times can myeloma relapse?

Most people will experience several remissions and relapses throughout their disease course. Every time you relapse, it can become more difficult to achieve remission.

What is the longest-known remission with multiple myeloma?

Research shows that some people diagnosed with multiple myeloma survive for over 20 years without experiencing a relapse.

Can multiple myeloma relapse after a stem cell transplant?

Although a stem cell transplant can improve your outlook with multiple myeloma, you can still experience a relapse. Relapse typically means the body can’t prevent cancer cells from growing bigger, either because of the type of cancer or because the body has lost the ability to identify and destroy cancer cells.

For multiple myeloma, the type of transplant done is usually an autologous stem cell transplant (ASCT), which involves transplanting your own stem cells.

Sometimes, ASCT can fail to produce blood cells as intended. It’s also possible for cancer cells to be collected and reintroduced during the procedure.

Multiple myeloma relapse is a return of symptoms after a period of improvement. Most people experience several relapses and periods of remission during their disease course.

It’s possible to live for many years after a relapse in multiple myeloma, but life expectancy depends on many factors.

Following a relapse, treatment may include a combination of options. You may also wish to ask your doctor about participating in a clinical trial investigating new therapies.