Monitoring minimal residual disease (MRD) is an essential part of managing multiple myeloma, as it helps determine how well treatment is working and guides future therapy decisions. 

The frequency of MRD testing can vary depending on several factors, including the type of myeloma, the stage of treatment, and individual patient needs.

General Recommendations for MRD Monitoring

• During treatment: MRD testing is often performed after major milestones in therapy, such as after induction therapy, post-transplant, and during maintenance therapy. This helps assess how effectively the treatment has reduced cancer cells.
• Maintenance phase: For patients on maintenance therapy, MRD can be monitored every 6 to 12 months. Regular MRD testing during this phase helps monitor sustained MRD negativity and detect early signs of relapse before symptoms appear.
• Post-treatment surveillance: In patients who have achieved sustained MRD negativity, testing may be done less frequently, such as annually. However, any signs of clinical relapse or changes in laboratory markers might prompt more frequent testing.

Special Considerations for Non-Secretory Myeloma Patients

For patients with non-secretory myeloma, where traditional blood and urine tests cannot effectively track the disease, MRD monitoring through bone marrow biopsies and advanced imaging techniques like PET scans becomes even more critical. These patients may require more frequent bone marrow biopsies and MRD assessments to ensure the disease remains under control, as standard markers are not reliable.

Individualized Approach

Ultimately, the frequency of MRD testing should be tailored to each patient’s unique situation. Factors influencing this include:

• Response to treatment
• Risk of relapse
• Type of myeloma 
• Overall health and treatment goals

Discuss with your healthcare team how often MRD testing is appropriate for you, as they can provide personalized recommendations based on your treatment response and disease characteristics.