Prognosis and duration

Relapsed or recurrent myeloma

Needs are likely to be identified in this group, disability is most likely to relate to bone pain, renal failure and drug side effects such as fatigue and neuropathy. Many will be terminally ill; this is particularly likely if relapse has happened within 6 months of first line treatment. If needs are identified life awards are recommended.

First line treatment of myeloma

People of working age and older ‘fit’ people

The group who have the PBSCT or bone marrow transplant have the best long term outcome. A return to health is expected in the typical case, time limited awards are recommended, recovery should be substantially complete 1 year after PBSCT or bone marrow transplant. However recurrence of disease is common, if disease has recurred renewal with indefinite award is recommended. Indefinite awards are recommended for those unable to have this treatment.

People over 65 and people of working age who are ‘unfit’

Of this group 55% will still be alive after one year. Those who respond to chemotherapy and go into remission are likely to be in the survivor group. Those who do not respond to treatment are more likely to be terminally ill.

This group are likely to have some symptoms and may have identifiable needs, time limited awards are recommended with review at 12-18 months. Those who will recover are likely to be well at this stage. For those in this group who relapse after a period of remission see relapsed or recurrent myeloma section.

Monoclonal Gammopathy of Undetermined Significance (MGUS)

There are no disabling effects associated with this condition.

Isolated Plasmacytoma of Bone

In the rare case where needs are identified during treatment awards should be time limited to coincide with completion of treatment and recovery – 6-9 months if chemotherapy is being used. If myeloma develops after successful treatment of this condition needs are likely to arise related to myeloma symptoms and treatment – please refer to the appropriate myeloma section.

Solitary extramedullary plasmacytoma

Treatment and recovery are complete within three months, enduring needs are not expected. If myeloma develops after successful treatment please follow guidance in myeloma section.

All information must be taken into account when considering the duration of disabling effects and the duration of disabling effects must be based on the particular circumstances of the individual claimant.

Amended February 2009