The prognosis for multiple myeloma varies widely, with survival ranging from less than one year in people with aggressive disease to more than 10 years in those with slowly progressing cancer. The American Cancer Society reports that 35 percent of people with multiple myeloma die within five years of diagnosis. Several factors affect prognosis including cancer stage, genetics, and the patient's age.
Staging
The staging of multiple myeloma, which determines how far the cancer has advanced, is an important predictor of survival. Multiple myeloma is classified into three stages. Stage I indicates the smallest amount of disease, while stage III signifies highly active disease. Doctors employ two staging systems. The Durie-Salmon system uses four measures, including the amount of bone damage. The simpler new system, the International Staging System for Multiple Myeloma, uses only two measures, the blood levels of albumin and beta-2-microglobulin.
Prognosis by Stage
According to studies using the International Staging System, the median survival rates for multiple myeloma are 62 months for stage I disease, 45 months for stage II disease, and 29 months for stage III cancer. Median survival is an average calculated by researchers, which refers to the time in which half the patients died. It is important to remember that survival times are computed from the time that treatment first began rather than when a patient was first diagnosed with the disease.
Five-Year Survival Rates
According to the American Cancer Society, most statisticians use five-year survival rates in their analyses, thus providing a standard tool for experts to discuss and compare prognosis. The five-year survival rate is the percentage of people who are alive five years after their cancer is diagnosed. The five-year survival rate is slightly higher for men than women, with about 36 percent of men alive at five years as compared to 29 percent of women.
Genetic Abnormalities
Due to recent advances in medicine, cancer cells can now be sent for tests that examine genes. Certain chromosome changes confer a poorer prognosis in multiple myeloma. Deletions or missing parts of chromosome 13 are associated with a lower survival rate, as are translocations--the exchange of parts between chromosomes 4 and 14.
Labeling Index
The plasma cell proliferation rate, also known simply as the labeling index, is a useful indicator. This test is performed in a specialized laboratory on myeloma cells that have been extracted from the patient's bone marrow. A high labeling index, one that exceeds 2 percent, predicts lower survival.
Other Factors
Other factors also affect prognosis. Kidney problems are associated with a lower survival rate. Age is another significant factor. Younger patients have higher survival rates, while older patients have a poorer prognosis. How well the patient responds to treatment also has a significant impact on prognosis.
References
- American Cancer Society: What Are the Key Statistics About Multiple Myeloma?
- American Cancer Society: How is Multiple Myeloma Staged?
- Dr. Arthur Schoenstadt, eMedTV: Multiple Myeloma Survival Rates
- "Cancer: Principles & Practice of Oncology"; Plasma Cell Neoplasms; DeVita V, ed.; 2005
