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Multiple myeloma - Treatment

Alternative Names

Plasma cell dyscrasia; Plasma cell myeloma; Malignant plasmacytoma; Plasmacytoma of bone; Myeloma - multiple

Treatment:

The goal of treatment is to relieve symptoms, avoid complications, and prolong life.

People who have mild disease or where the diagnosis is not certain are usually carefully watched without treatment. Some people have a slow-developing form of multiple myeloma that takes years to cause symptoms.

Medications for the treatment of multiple myeloma include:

  • Dexamethasone, melphalan, cyclophosphamide, doxil, thalidomide, lenalidomide (Revlimid), and bortezomib (Velcade) can be used alone or combined together.
  • Bisphosphonates (pamidronate) to reduce bone pain and prevent fractures.

Radiation therapy may be done to relieve bone pain or treat a bone tumor.

Two types of bone marrow transplantation may be tried:

  • Autologous bone marrow or stem cell transplantation makes use of one' s own stem cells. In younger patients, it has been shown to increase survival.
  • Allogeneic transplant makes use of someone else' s stem cells. This treatment carries serious risks but offers the chance of a cure.

People with multiple myeloma should drink plenty of fluids to prevent dehydration and help maintain proper kidney function. They should also be cautious when having x-ray tests that use contrast dye.

Support Groups:

The stress of illness may be eased by joining a support group whose members share common experiences and problems. See: Cancer - support group

Expectations (prognosis):

Survival of people with multiple myeloma depends on the patient's age and the stage of disease. Some cases are very aggressive, while others take years to get worse.

Chemotherapy and transplants rarely lead to a permanent cure.

Complications:

Kidney failure is a frequent complication. Other complications may include:

  • Bone fractures
  • High levels of calcium in the blood, which can be very dangerous
  • Increased chances for infection (especially pneumonia)
  • Paralysis from tumor or spinal cord compression

Calling your health care provider:

Call your doctor if you have multiple myeloma and infection develops, or numbness, loss of movement, or loss of sensation develops.

  • Reviewed last on: 2/28/2011
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

National Comprehensive Cancer Network. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Multiple Myeloma. 2011. Version 1.2011. Accessed January 29, 2011.

Rajkumar SV, Dispenzieri A. Multiple myeloma and related disorders. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKenna WG, eds. Abeloff’s Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 110.

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