Multiple Myeloma Prognosis: Survival Rates and More

Multiple myeloma is a type of blood cancer that develops in plasma cells, a type of white blood cell in your bone marrow. Treatment for multiple myeloma is important for the cancer’s overall prognosis. Untreated, multiple myeloma can cause kidney damage or failure, bone fractures, cardiac arrest, or coma. 

The prognosis of multiple myeloma can depend on the stage of disease at diagnosis, your age, and how well you respond to treatment. While there is no cure for multiple myeloma, treatment advancements in the last decade—from targeted drugs to stem cell transplants—have helped improve treatment outcomes and survival rates. 

Healthcare providers classify multiple myeloma into stages using the Revised International Staging System (RISS). This system considers four factors to determine which stage of multiple myeloma you have: 

• Albumin levels: Albumin is the most common protein in the blood. With multiple myeloma, levels of the chemical messenger interleukin-6 (IL-6) increase. IL-6 limits albumin production and leads to low albumin levels.
• Beta-2 microglobulin: Beta-2 microglobulin is a blood protein that myeloma cells produce. The protein’s levels increase as multiple myeloma progresses. 
• Lactate dehydrogenase (LDH): LDH is an enzyme that helps cells make energy. LDH levels increase as multiple myeloma grows. 
• Gene abnormalities: Genetic testing on myeloma cells can help identify abnormalities like gene mutations (changes) associated with more aggressive multiple myeloma.

There are three stages of multiple myeloma. Each stage represents how far the cancer has progressed, meaning how much cancer is in the body. 

Stage 1

Stage 1 is the earliest stage of multiple myeloma. People with stage 1 have lower levels of beta-2-microglobulin (below 3.5 milligrams per liter) and higher albumin levels (3.5 grams per deciliter or higher). LDH levels are normal, and the cancer cells have no high-risk genetic abnormalities.

In this stage, there are generally few cancer cells throughout the body, and people have few to no symptoms of multiple myeloma.

Stage 2

Stage 2 multiple myeloma is an intermediate phase. This means the blood test markers and cancer genetic markers fall between those of stages 1 and 3—the cancer is no longer in its early stage but not yet in a more advanced stage.

Beta-2-microglobulin levels are above 3.5 milligrams per liter but lower than 5.5 milligrams per liter, while albumin levels and LDH may vary. Genetic abnormalities may or may not be present. In stage 2, there is a moderate amount of cancer throughout the body, and people may begin to experience more noticeable symptoms.

Stage 3

Stage 3 multiple myeloma is the most advanced stage. People in this stage have high beta-2-microglobulin levels (5.5 milligrams per liter or higher), high-risk genetic abnormalities in the cancer cells, and/or high LDH levels.

In stage 3, a significant amount of cancer is in the body, and people may experience moderate to severe symptoms, including weakness, fatigue, bone pain, loss of appetite, and frequent infections.

Survival rates for multiple myeloma provide an estimate of the percentage of people who are likely to live for a certain period after their diagnosis. While survival rate statistics can help you understand the typical progression of the disease, these numbers don’t account for factors like overall health, response to treatment, or recent advancements in treatment options.

In multiple myeloma, the five-year relative survival rate—the proportion of people who live at least five years after the initial diagnosis—varies widely depending on the stage of the disease. Generally, survival rates are higher for earlier-stage diagnoses and lower for advanced stages. It’s important to remember that survival rates are only estimates; they cannot predict your outcome.

According to the most recent data from 2014-2020, the overall five-year relative survival rate for multiple myeloma is 61.1%. 

People diagnosed with multiple myeloma today may have a more positive outlook than these statistics suggest. As experts’ understanding of the disease increases and treatment options become more effective, survival rates and outcomes will likely continue to improve.   

The prognosis of multiple myeloma, meaning the expected course of the disease, varies from person to person. Several factors can influence your prognosis, from your overall health to characteristics of the disease such as its stage. 

Factors that affect multiple myeloma prognosis include:

• Age: Younger people generally have better outcomes than older adults. Younger people may be more resilient to intensive treatments, and older adults may have other health conditions that complicate or limit multiple myeloma treatment options.
• Overall health: Your overall health can affect your ability to undergo and tolerate treatment. Underlying conditions, such as diabetes or heart disease, can affect treatment effectiveness and outcomes. 
• Stage of disease: People who receive a multiple myeloma diagnosis at an earlier stage typically have a more favorable prognosis. Generally, early diagnosis means the cancer is easier to treat. 
• Genetic markers: Certain genetic markers in cancer cells suggest a more aggressive form of myeloma, which can influence the way the disease responds to treatment and affect prognosis. 
• Treatment response: People who respond well to first-line therapies, such as chemotherapy or stem cell transplantation, often have a better long-term outlook.
• Complications: Complications like kidney damage, high calcium levels (hypercalcemia), and bone fractures can affect treatment decisions and prognosis. 

A multiple myeloma diagnosis can take a physical and emotional toll on nearly every aspect of life. Fortunately, there are ways to improve your physical and emotional well-being and to help ensure you lead a fulfilling life with multiple myeloma:

• Follow your treatment plan: Working closely with your healthcare team and following your treatment plan is the best way to ensure your treatments are effective and keep your symptoms under control.
• Prioritize nutrition: Eating a well-balanced diet rich in fruits, vegetables, lean proteins, fiber, and whole grains can support a healthy gut microbiome and strengthen your immune system, helping improve treatment outcomes. 
• Regular physical activity: Regular exercise, such as walking, swimming, or yoga, can help boost energy, maintain your flexibility and muscle strength, decrease pain, and improve your quality of life.
• Build a strong support network: Your family, friends, and overall community can make daily life more manageable, boost your mood, and help you feel less alone. Lean on your community to help with everyday activities, discuss how you’re feeling, or engage in activities you enjoy.  
• Seek mental health support: Coping with a cancer diagnosis can be overwhelming. Talking with a therapist or joining a multiple myeloma support group can provide a safe space for you to share and process your experiences and emotions with others who understand. 
• Stay informed: Experts’ understanding of multiple myeloma and its treatment options is constantly evolving and improving. Discussing the latest therapies or clinical trials with your healthcare provider can open doors to potentially beneficial treatments and give a sense of hope and control.
• Focus on self-care and relaxation: Incorporating relaxation practices like meditation, deep breathing exercises, massage, or yoga can help relieve stress and improve your overall mental health and well-being. 

Multiple myeloma is a blood cancer that affects plasma, a type of white blood cell in the bone marrow. There are three stages of multiple myeloma, and the stage you receive at diagnosis gives an overall picture of how far the disease has progressed and helps inform treatment decisions. 

Your multiple myeloma prognosis—meaning the estimated course of the disease—depends on factors like your age, overall health, stage at diagnosis, and how your body responds to treatment. While multiple myeloma is incurable, treatment advancements have led to significant improvements in survival rates for people with the disease. As newer and more effective treatments become available, more people will continue to survive and live well with multiple myeloma.