Relapsed or refractory multiple myeloma is a form of multiple myeloma, a cancer that starts in plasma cells in the bone marrow. Biomarker test results help guide what comes next. For you or your loved one, whether this is a first diagnosis or the cancer has come back, compare FDA-approved treatment options.
- Relapsed Multiple Myeloma
- Refractory Multiple Myeloma
Overview
Relapsed Active Multiple Myeloma diagnosis means that your multiple myeloma was initially treated and responded to therapy, but the disease has returned after a period of remission or stable disease.
What tests will I need and Why?
A Multiple Myeloma diagnosis and risk level is determined using a variety of tests to see how advanced the condition is and whether it’s likely to progress. Here’s an overview of the main tests:
Blood Tests:
Complete Blood Count (CBC) checks for low levels of red blood cells, white blood cells, or platelets, which can indicate bone marrow issues.
Serum Protein Electrophoresis (SPEP) measures the level of abnormal proteins being produced by cancerous plasma cells.
Calcium Levels to determine if bone damage has been caused by multiple myeloma.
Creatinine Levels assess kidney function, which can be affected by multiple myeloma.
Urine Tests: find any abnormal proteins which are produced by abnormal plasma cells.
Bone Marrow Biopsy: primarily used to check the percentage of abnormal plasma cells verses normal plasma cells and to perform genetic testing to look for genetic abnormalities that may be linked to higher risk.
Imaging Tests: An X-ray, MRI and Pet Scan look for any bone damage or active disease.
Re-read this summary as needed and then tap, “Compare My Treatment Options Now“. Our unique Comparison Page will help you understand your FDA-approved treatment options including, who can help you pay for your treatment, where and how each is given and what side-effects you may experience.
National Institute of Health/ treatment-active-myeloma
Overview
A Refractory Active Multiple Myeloma diagnosis means that your multiple myeloma is actively progressing and has not responded to previous treatments, even after completing multiple treatments.
What tests will I need and Why?
A Multiple Myeloma diagnosis and risk level is determined using a variety of tests to see how advanced the condition is and whether it’s likely to progress. Here’s an overview of the main tests:
Blood Tests:
Complete Blood Count (CBC) checks for low levels of red blood cells, white blood cells, or platelets, which can indicate bone marrow issues.
Serum Protein Electrophoresis (SPEP) measures the level of abnormal proteins being produced by cancerous plasma cells.
Calcium Levels to determine if bone damage has been caused by multiple myeloma.
Creatinine Levels assess kidney function, which can be affected by multiple myeloma.
Urine Tests: find any abnormal proteins which are produced by abnormal plasma cells.
Bone Marrow Biopsy: primarily used to check the percentage of abnormal plasma cells verses normal plasma cells and to perform genetic testing to look for genetic abnormalities that may be linked to higher risk.
Imaging Tests: An X-ray, MRI and Pet Scan look for any bone damage or active disease.
Re-read this summary as needed and then tap, “Compare My Treatment Options Now“. Our unique Comparison Page will help you understand your FDA-approved treatment options including, who can help you pay for your treatment, where and how each is given and what side-effects you may experience.
Replay this Audio as often as needed and then take a look at our Commonly Searched Questions below.
National Institute of Health/ treatment-active-myeloma
Biomarkers In Multiple Myeloma
Biomarker Testing
Why Do Biomarkers Matter in Multiple Myeloma?
Your biomarker results are your doctor’s main window into how active your myeloma is — and whether treatment is working.
Unlike most cancers, multiple myeloma is tracked mainly through blood and urine tests. Myeloma cells produce an abnormal protein that can be measured. Tracking that protein over time is one of the most important parts of your care. Talk to your doctor about your M protein level and how it will be tracked throughout your care.
myeloma patients
M Protein — Is There an Abnormal Protein in Your Blood or Urine?
M protein is made by myeloma cells. It is measured by blood and urine tests. As treatment works, M protein falls. If it rises again, myeloma may be coming back. Ask your doctor what your M protein level is and what changes to watch for.
myeloma patients
Free Light Chains — Are Protein Fragments From Myeloma Cells Detectable?
Free light chains are pieces of M protein. The ratio of two types helps track disease activity alongside M protein. Ask your doctor what your free light chain results mean.
by patient
Cytogenetics / FISH — What Do Your Chromosome Test Results Show?
FISH testing on your bone marrow looks for specific chromosome changes linked to more aggressive myeloma. Knowing your cytogenetic profile helps your doctor choose the most appropriate care approach. Ask your doctor what your FISH results showed.
Quick Poll
Have you been biomarker tested?
Source: DaCosta Byfield et al., JAMA Network Open, July 2025 · jamanetwork.com
Sources: National Cancer Institute (cancer.gov) · IMF · American Cancer Society · Updated August 2026
Recommended Multiple Myeloma Videos
Multiple Myeloma: Symptoms, Treatment, and Patient Care
Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell.
What Causes Multiple Myeloma?
Learn how an abnormal growth of plasma cells can lead to the formation of multiple myeloma
How is Multiple Myeloma Diagnosed and What Testing is Necessary After?
What testing is involved in multiple myeloma diagnosis and treatment?
What Are the Beginning Stages of Multiple Myeloma (MM)?
What happens in early stages of multiple myeloma?
How is Multiple Myeloma Staged?
Watch as expert Dr. Abdullah Khan explains staging and its use, and myeloma patient and Empowerment Lead Lisa Hatfield shares how the use of staging and its factors have evolved over time.
What is Myeloma?
Find out about what myeloma is, how it starts, symptoms, and how your specialist plans the best treatment for you.
Commonly Searched Questions
Relapsed/refractory Multiple Myeloma Definition
Cancer.org
Relapsed/refractory Multiple Myeloma Symptoms
- Bone pain, often in the back, ribs, or hips, due to bone damage or fractures.
- Fatigue and weakness from anemia, caused by a decrease in red blood cells.
- Frequent infections due to a weakened immune system.
- Kidney problems, including kidney failure, caused by the buildup of abnormal proteins produced by the myeloma cells.
- Numbness or weakness in the legs or other neurological symptoms, often due to spinal cord compression from bone damage.
Cancer.org
Relapsed/refractory Multiple Myeloma Prevention
Cancer.org
Relapsed/refractory Multiple Myeloma Treatment
- Chemotherapy: New chemotherapy drugs may be used if previous ones are no longer effective.
- Immunotherapy: Medications that help stimulate the immune system to attack myeloma cells.
- Targeted therapy: Drugs that target specific molecules involved in the growth of myeloma cells.
- Stem cell transplant: A procedure to replace damaged bone marrow with healthy stem cells, often used in relapsed cases.
- Corticosteroids: To reduce inflammation and help control disease progression.
Cancer.org
Relapsed/refractory Multiple Myeloma Recurrence Rate
Cancer.org
Relapsed/refractory Multiple Myeloma Survival Rate
Cancer.org
Most Frequently Asked Questions
Does the myeloma survival rate apply after relapse?
The SEER number measures survival from diagnosis, not from relapse. About 64 in 100 people with myeloma (63.7%) are alive 5 years after diagnosis. Ask the care team what this means after relapse.
Can biomarker results change for relapsed or refractory multiple myeloma?
Yes. Cancer cells can change over time, so doctors may test biomarkers again when the cancer comes back or treatment stops working. For multiple myeloma, key markers include M Protein, Beta-2 Micro, and FLC. See the biomarker guide.
What if relapsed or refractory multiple myeloma comes back or gets worse?
Cancer that returns is called a recurrence. Doctors repeat many of the same tests to find where it is and how far it has spread. The new treatment plan may match the first one or change.
Where can I compare treatment options for relapsed or refractory multiple myeloma?
XpertPatient's treatment comparison for relapsed or refractory multiple myeloma shows options side by side. Review it with the care team, whether this is a first diagnosis or the cancer has returned.
