After 6 cycles of DRd
If you decide to continue taking part in the research, your hospital doctor will not decide what further treatment you get after 6 cycles of DRd.
Which treatment you may be allocated to will be based on:
How well you have responded to DRd
The bone marrow aspirate (fluid) sample after you complete 6 cycles of DRd will be sent to the iFIT laboratory (the Haematological Malignancy Diagnostic Service (HMDS) in Leeds) for testing. The result of the test will either be MRD positive (‘MRD+’) or MRD negative (‘MRD-’). MRD stands for measurable residual disease, i.e., how much myeloma is detected in your bone marrow.
If you are MRD+, this means you have current detectable myeloma cells in your bone marrow, so the disease remains present.
If you are MRD-, this means you do not currently have detectable myeloma cells in your bone marrow, so the disease is currently in a very deep response.
You might have a type of myeloma which cannot be measured in this way. If this is the case, your hospital doctor will discuss this with you. You may still be able to take part in the research as MRD positive (‘MRD+’).
Your level of fitness
We will use a well-tested process to assess your level of fitness, in other words, how frail you are. The process is the ‘International Myeloma Working Group (IMWG) frailty score’. The score considers your age, other illnesses, and whether you can live independently. It includes three groups: fit, unfit, and frail. You will be put into a group that best matches your level of fitness.