I've heard the term 'stable disease' in reference to myeloma. I assume this means there is some detectable myeloma, but it's not getting worse. What does it mean in terms of your numbers?
RT
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RadiantTiger - Name: Radiant Tiger
- Who do you know with myeloma?: Myself, my deceased uncle
- When were you/they diagnosed?: Feb 2015
- Age at diagnosis: 54
Re: What is 'stable disease'?
Hi RadiantTiger,
I enjoyed three years of 'stable disease' following initial Velcade, Revlimid, and dexamethasone (VRD) treatment in 2012 until October 2015. It has been a period of normal or near normal blood test results, the electrophoresis test would sometimes show 'polyclonal elevations' but never 'monoclonal'.
For me, the monoclonal protein showed up again in the month following a total thyroidectomy carried out in September of 2015. Tests showed my enlarged thyroid gland was completely benign. The monoclonal peak increased in a linear manner for nine months at which time I recommenced treatment (June 2016).
My medical certificate shows a stage three diagnosis in January 2012 that did not attain a full response but nevertheless led to an excellent treatment-free period, which I still enjoy today, four years later, despite the fact that treatment is again in progress.
I enjoyed three years of 'stable disease' following initial Velcade, Revlimid, and dexamethasone (VRD) treatment in 2012 until October 2015. It has been a period of normal or near normal blood test results, the electrophoresis test would sometimes show 'polyclonal elevations' but never 'monoclonal'.
For me, the monoclonal protein showed up again in the month following a total thyroidectomy carried out in September of 2015. Tests showed my enlarged thyroid gland was completely benign. The monoclonal peak increased in a linear manner for nine months at which time I recommenced treatment (June 2016).
My medical certificate shows a stage three diagnosis in January 2012 that did not attain a full response but nevertheless led to an excellent treatment-free period, which I still enjoy today, four years later, despite the fact that treatment is again in progress.
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Victor L - Name: Victor L
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2012
- Age at diagnosis: 58
Re: What is 'stable disease'?
I've found that different publications seem to have different definitions of what stable multiple myeloma is. Most say that stable disease is where one has less than 25% (but > 0%) of the original M-protein level that was present prior to treatment. Other publications use the term more loosely to simply mean that one's numbers have plateaued.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What is 'stable disease'?
Actually, "stable disease" is an IMWG-defined treatment response, just like "complete response" and "partial response" are IMWG-defined treatment responses.
In fact, "stable disease" (SD) is defined to be the response you've had if you have not achieved either a partial, very good partial, or complete response (PR, VGPR, or CR), and you're also not experiencing progressive disease (PD).
So, stable disease is basically the space between a partial response and progressive disease.
If you have multiple myeloma with an M-spike – i.e., you don't have light chain myeloma – then you would have stable disease as a result of treatment if your M-spike did not decline 50 percent or more, but also did not increase 25 percent or more.
See Table 1 in this article for more details:
Rajkumar, SV, et al, "Consensus recommendations for the uniform reporting of clinical trials: report of the International Myeloma Workshop Consensus Panel 1," Blood, 2011 (full text of article)
In fact, "stable disease" (SD) is defined to be the response you've had if you have not achieved either a partial, very good partial, or complete response (PR, VGPR, or CR), and you're also not experiencing progressive disease (PD).
So, stable disease is basically the space between a partial response and progressive disease.
If you have multiple myeloma with an M-spike – i.e., you don't have light chain myeloma – then you would have stable disease as a result of treatment if your M-spike did not decline 50 percent or more, but also did not increase 25 percent or more.
See Table 1 in this article for more details:
Rajkumar, SV, et al, "Consensus recommendations for the uniform reporting of clinical trials: report of the International Myeloma Workshop Consensus Panel 1," Blood, 2011 (full text of article)
Re: What is 'stable disease'?
I stand corrected. Thanks Terry.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What is 'stable disease'?
So, as Terry says: "stable disease is basically the space between a partial response and progressive disease."
I wonder how long people can stay in this state after they've had full-blown myeloma, transplant, etc.?
I guess this is a bit like 'smoldering myeloma', in that disease is present, but (hopefully) very slow-moving.
RT
I wonder how long people can stay in this state after they've had full-blown myeloma, transplant, etc.?
I guess this is a bit like 'smoldering myeloma', in that disease is present, but (hopefully) very slow-moving.
RT
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RadiantTiger - Name: Radiant Tiger
- Who do you know with myeloma?: Myself, my deceased uncle
- When were you/they diagnosed?: Feb 2015
- Age at diagnosis: 54
Re: What is 'stable disease'?
RT,
Even though "stable disease" is a defined treatment response like "partial response" and a "very good partial response", that doesn't mean the phrase is always used to convey that particular meaning. There are many times the phrase is used more loosely.
For example, a doctor or nurse might describe a patient's disease as "stable", and mean nothing more than the disease isn't moving in one direction or the other. They may have no intention of implying that that patient had a response to their most recent treatment that was in the "stable disease" category.
Take care
Even though "stable disease" is a defined treatment response like "partial response" and a "very good partial response", that doesn't mean the phrase is always used to convey that particular meaning. There are many times the phrase is used more loosely.
For example, a doctor or nurse might describe a patient's disease as "stable", and mean nothing more than the disease isn't moving in one direction or the other. They may have no intention of implying that that patient had a response to their most recent treatment that was in the "stable disease" category.
Take care
Re: What is 'stable disease'?
I agree with Terry on how doctors talk about multiple myeloma. If a person is not in remission after treatment and thus has some measurable disease that is not getting worse, then they are stable. The term stable is often loosely used, in that the numbers can bounce around some, but the disease is not relapsing, so that a re-start or change in existing treatment is not required.
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Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
Re: What is 'stable disease'?
Hello All,
I have been in "stable disease" since my stem cell transplant in May 2014. My protein levels have been bouncing between 10 - 15. It is my understanding that until these levels increase to upwards of 25, I will still be considered to be "stable".
Whilst there are no guarantees, my doctor is hopeful this stability will last 5 years or more. We will see.
I never reached a complete response. I think officially I was considered as a very good partial response (VGPR). However, stable is a good place to be for the time being. Every stage or level is just about buying time in my opinion.
Anyway, that is my laymen understanding of stable.
Vicki
I have been in "stable disease" since my stem cell transplant in May 2014. My protein levels have been bouncing between 10 - 15. It is my understanding that until these levels increase to upwards of 25, I will still be considered to be "stable".
Whilst there are no guarantees, my doctor is hopeful this stability will last 5 years or more. We will see.
I never reached a complete response. I think officially I was considered as a very good partial response (VGPR). However, stable is a good place to be for the time being. Every stage or level is just about buying time in my opinion.
Anyway, that is my laymen understanding of stable.
Vicki
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vicstir - Name: Vic
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: October 2013
- Age at diagnosis: 39
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