In many cancers you hear about the concept of “stages” to describe the progression or classification of the disease. Multiple myeloma doctors use the concept of “risk” to place people in different disease categories.
Not everybody who gets multiple myeloma has the same risk. Some patients have what is called standard risk. Other patients are high-risk. And the risk depends upon irregularities in the chromosomes of their cancer cells:
- Standard RiskThis is typically characterized by extra copies of some of the chromosomes.
- High RiskThis is typically characterized by a missing part of chromosome number 17
These gene differences control the aggressiveness of the cancer cells. Standard risk has “a better prognosis” whereas high risk myeloma “confers a much poorer outcome,” according to Dr. Kenneth Anderson, Director of the Multiple Myeloma Center at Dana Farber Cancer Institute. So when it comes to treatment, in the first two phases there is no difference. But the treatment approach differs in the third phase. Here’s how it works.
- Induction Phase: This phase is the same regardless of risk. It consists of a triplet drug therapy
- Stem-Cell Transplant Phase: This phase is the same regardless of risk. It consists of chemotherapy coupled with a stem-cell transplant.
- Maintenance Phase: This phase will differ based on the risk-profile.
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