Multiple myeloma is uncommon but not exceptionally rare. An estimated 36,000 new cases will be diagnosed in the United States in 2026, and roughly 202,793 people were living with the disease as of 2023. That puts it right at the boundary of what the U.S. officially considers a “rare disease,” making it one of the more common blood cancers even as it remains a small fraction of all cancer diagnoses.
Where Myeloma Falls on the Rarity Scale
Under the Orphan Drug Act, the FDA defines a rare disease as one affecting fewer than 200,000 people in the United States. With just over 202,000 people currently living with myeloma, the disease has recently crossed that threshold. For years it sat firmly in rare territory, but improved survival rates and steady new diagnoses have pushed the living patient count upward. In practical terms, myeloma accounts for roughly 1.8% of all new cancer cases each year, placing it well behind cancers of the breast, lung, and colon, but ahead of many cancers most people have heard of.
To put the numbers in perspective, about 36,000 Americans will be diagnosed this year compared to roughly 300,000 new breast cancer cases and 230,000 new lung cancer cases. Myeloma is the second most common blood cancer after non-Hodgkin lymphoma, so within hematology it is far from obscure. An estimated 10,850 people will die from it in 2026.
Who Gets Multiple Myeloma
Myeloma is strongly age-related. Most people are diagnosed in their late 60s or early 70s, and it is quite rare in anyone under 40. Men are diagnosed somewhat more often than women, though the gap is modest.
Race is one of the strongest risk factors. Black men and women develop myeloma at more than twice the rate of non-Hispanic White individuals: 14.4 cases per 100,000 people compared to 6.4. Hispanic and Latinx populations also face higher incidence rates and tend to be diagnosed at younger ages. These disparities are compounded by gaps in access to newer treatments. Research published in Blood Advances found that Hispanic and Latinx patients experience both underutilization of standard therapies and delays in starting treatment compared to non-Hispanic White patients.
The Precursor Condition Most People Don’t Know About
Almost all cases of multiple myeloma are preceded by a condition called MGUS (monoclonal gammopathy of undetermined significance). MGUS itself is far more common than myeloma: it shows up in about 3% of adults over age 50 on routine blood work. On average, about 1% of people with MGUS go on to develop myeloma each year. That means the vast majority of people with MGUS will never progress to cancer, but the condition does require long-term monitoring.
Between MGUS and full-blown myeloma sits an intermediate stage called smoldering myeloma. People at this stage have higher levels of abnormal plasma cells in the bone marrow but no symptoms like bone damage, kidney problems, or anemia. The risk of progressing from smoldering myeloma to active disease varies dramatically depending on specific lab findings. For example, when abnormal plasma cells make up 60% or more of the bone marrow, the chance of progressing to symptomatic myeloma within two years is about 95%. On the other hand, patients with lower-risk smoldering disease may be monitored for years without needing treatment.
Racial Disparities in Incidence and Outcomes
The gap between Black and White Americans is striking not just in how often myeloma occurs but in outcomes afterward. Black patients develop the disease more than twice as frequently, and while some studies suggest they respond well to newer treatments when they receive them, access remains uneven. Socioeconomic barriers, insurance gaps, and geographic distance from specialized cancer centers all contribute to delayed diagnosis and undertreatment.
Hispanic and Latinx patients face a similar pattern of higher incidence combined with barriers to care. Because myeloma is often diagnosed through routine blood tests that reveal abnormal proteins, populations with less consistent access to primary care may be diagnosed later, when the disease has already caused organ damage.
How Survival Has Changed
One reason the number of people living with myeloma has grown past the 200,000 mark is that survival has improved substantially over the past two decades. In the early 2000s, the five-year survival rate hovered around 30 to 35%. Today it is closer to 60%, driven largely by newer classes of treatment introduced since the mid-2000s. For younger patients who are eligible for stem cell transplant, outcomes are often better still.
Myeloma remains considered incurable for most patients, meaning treatment controls the disease rather than eliminating it permanently. Many people go through cycles of treatment and remission over years or even decades. The practical result is a growing population of people managing myeloma as a chronic condition, which is exactly why the prevalence numbers keep climbing even though the annual diagnosis rate has stayed relatively stable.
What “Rare” Means for Patients
Whether myeloma technically qualifies as rare matters beyond semantics. Rare disease designation opens the door to orphan drug incentives, which have historically encouraged pharmaceutical companies to develop treatments they might otherwise skip. Many of the drugs that transformed myeloma care were developed under these incentives. Now that the living patient count has edged above 200,000, the regulatory landscape could shift, though existing orphan drug approvals are not retroactively revoked.
For patients, the practical reality is that myeloma is common enough to have a robust treatment pipeline and active clinical trial network, but uncommon enough that many community oncologists see only a handful of cases per year. Specialized myeloma centers and academic medical institutions tend to offer the widest range of treatment options, which is one reason outcomes vary significantly by where you receive care.