Refractory Multiple Myeloma

Stages of Multiple Myeloma

Multiple myeloma is a cancer that affects plasma cells, a type of white blood cell responsible for producing immune factors such as antibodies. It is characterized by the accumulation of cancerous plasma cells in the bone marrow. The cancer progresses through four distinct stages: smoldering, active, relapsed, and refractory.

Refractory Multiple Myeloma

Refractory multiple myeloma is the most advanced stage of the cancer. It occurs when the cancer is unresponsive to treatment with conventional chemotherapy or targeted therapy. In other words, the cancer does not respond to drugs that previously controlled the disease. Refractory multiple myeloma is considered a terminal stage, as it is associated with poor prognosis and typically progresses rapidly.


The symptoms of refractory multiple myeloma vary widely and may depend on individual factors such as age, health status and the extent of the disease. Common symptoms include:

  • Fatigue
  • B breathlessness
  • Frequent infections
  • Unexplained weight loss
  • Bone pain
  • Hypercalcemia (elevated calcium levels in the blood)
  • Kidney failure
  • Anemia


Diagnosing refractory multiple myeloma requires a thorough evaluation by a cancer specialist. The doctor may perform a physical examination and order imaging tests such as CT or MRI scans, blood tests, and a sample of bone marrow and a PET scan for a more detailed picture of the disease. In some cases, a biopsy of the bone marrow may be requested as well.


Unfortunately, there is no standard of care for refractory multiple myeloma, and strategies for treating the disease are still being developed. Treatment options may include high-dose chemotherapy, autologous stem cell transplant, or immunotherapy. The doctor may also suggest palliative care or clinical trials as treatment options.