1) What is the median life expectancy for someone with stage 3 Myeloma (assume this person is in otherwise good health and in their early 60s)?
2) What is the average age for someone diagnosed with multiple myeloma?
3) What is the difference between multiple myeloma and Light-Chain multiple myeloma?
4) How is remission progress measured in someone with Light-Chain multiple myeloma? They seem to be measuring my father's "light chain number," however on these forums I see no mention of that number and greater mention of the "M Protein." What is the difference, if any?
Any answers would be greatly appreciated. Thanks!
* For Beacon news articles related to life expectancy, see this link.
* For other forum discussions related to life expectancy, see this link.
- Name: bitca88
- Who do you know with myeloma?: Father
- When were you/they diagnosed?: December 2011
- Age at diagnosis: 61
The life expectancy question is always a challenge to answer. The International Staging System (ISS) for myeloma is widely used internationally. There is an older staging system called the Durie Salmon staging system as well. Both have their merits.
Assuming that you are referring to Stage III disease by the ISS criteria the predicted median overall survival is 29 months. But......it is very important to remember that these are statistics and cannot tell us exactly how an individual patient will do. Patients are not numbers or statistics. Everyone is unique. Your life could be longer or shorter than these numbers report. The staging systems give us valuable guidance as to what to expect but they are not a crystal ball.
One of the most important prognostic markers in 2012 is the genetics of the myeloma. When the ISS and Durie Salmon systems were devised we did not have cytogenetic markers and therefore they are not part of the currently available staging systems. This is a major weakness of the currently avaiable prognostic systems.In addition, young patients (less than or equal to 65 years of age) tend to do significantly better than older patients. Age is also not used in the current prognostic systems.
In general, by cytogenetics, patients may be classified as "standard risk" myeloma, "intermediate" risk or "high" risk. The majority of patients (roughly 75%) are standard risk.
High risk = FISH Del 17p, t(14;16), t(14;20) or GEP with a High risk signature.
Intermediate risk = FISH t(4;14), Cytogenetic (not FISH) Deletion 13 or hypodiploidy
Standard risk = All others including: Hyperdiploid, t(11;14), t(6;14)
Risk = how rapidly the myeloma progresses and the expected lifespan for the patient.
The average age of newly diagnosed patients with myeloma is 70.
In terms of prognosis there is no real difference for patients with light chain myeloma from the other forms.
The progress of light chain myeloma is usually followed by the measurement of serum free light chains or with a 24 hour urine for light chains (Bence Jones proteins).
Best of luck !
University of Washington & Fred Hutchinson Cancer Research Center
Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.
Dr. Edward Libby
- Name: Edward Libby, M.D.
Beacon Medical Advisor
The International Myeloma Foundation (can be accessed through "links" in the sidebar), publishes a free booklet on Serum Free Light Chains that should answer many of your questons. It is basic and easy to read. See the link I provided in this previous posting (above):
- Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
> I will respond about the life expectancy. Do not, I repeat do not even
> concern yourself with these statistics. I refuse to read or listen to any
> talk about survival time. This disease is so unique to everyone, there is
> no way to tell. I have 2 members in my group that are 21 and 20 year
> survivors, another member is 14 years and I am a 8 1/2 year survivor and I
> plan on being around a lot longer. Tell your dad to keep a positive
> attitude and hold on to the hope that there is a cure right around the
> corner. I am a self advocate, I know enough about multiple myeloma to
> understand the treatments and I can carry on an intelligent conversation
> with my doctor, but I stay away from statistics.
Thank you kaycrombie! Ive been out of my mind thinking my husband may die in a few short months! you have given me some hope. Now I can breathe!
Approached another way, these expectancy number reflects results of older therapies, BUT we are in an era of better comprehension of various cancers, AND with newer drugs which can target cells in ways that were not even conceived of in 2000. (Our oncologist told us that she has anecdotal evidence from her myeloma patients that median survival has significantly improved over the published number above.)
So, we all are part of the experimental phase of the struggle against cancer. As well, each person brings unique genetic and environmental circumstances to the battle, such that the best advice was written earlier: just ignore the expectancy numbers.