New treatments for multiple myeloma - Mayo Clinic



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How to Treat Multiple Myeloma

Two Methods:

Multiple myeloma is a cancer of the plasma cells, which are a subtype of your white blood cells.Plasma cells are found primarily in the bone marrow, as well as in some other areas of the body. If you have been diagnosed with multiple myeloma, there are a variety of treatment options available. Although it is challenging to completely cure multiple myeloma, it is possible in some cases, and treatment is very likely to improve the condition as well as your prognosis moving forwards.

Steps

Trying Medical Treatments

  1. Opt for standard chemotherapy.Standard chemotherapy agents include Melphalan (Algerian), Cyclophosphamide (Cytoxan), Doxorubicin (Adriamycine), and Liposomal Doxorubicin (Doxil). Chemotherapy is often quite successful at controlling multiple myeloma; however, used on its own, it is rarely fully curative (although there are some case reports where it has lead to full remission of the cancer).
  2. Ask your doctor for a steroid prescription.Steroids commonly used in the treatment of multiple myeloma include Dexamethasone and Prednisone. Dexamethasone is most commonly used, and it can be prescribed either as a tablet or as an injection.
    • Dexamethasone works both by diminishing inflammation and potential pain caused by the cancer, as well as by inducing death of the cancer cells themselves, so the benefits of the drug are several-fold.
  3. Try the newer drugs specifically for multiple myeloma.A number of new drugs have emerged as new possibilities for the treatment of multiple myeloma and have recently been approved for treatment. These include thalidomide (Thalomid), lenalidomide (REVLIMID), bortezomib (Velcade), carfilzomib (Kyprolis), ixazomib (Ninlaro), and pomalidomide (Pomalyst). These are most often considered for new diagnoses of multiple myeloma, and/or for cases that have been unsuccessful at being cured via other methods. Speak to your doctor for further information about considering these new drugs.
  4. Receive immunotherapy.The names of these medications are elotuzumab (Empliciti) and daratumumab (Darzalex). They are specifically designed to target the cancer cells via immunological mechanisms (using antibodies that attach specifically to cancerous cells), with the goal of removing these cancerous cells from the body.
    • Immunotherapy is often used for people whose multiple myeloma has continued to progress, despite the trial of other medical therapies.
  5. Consult your doctor to determine the ideal treatment plan for you.Ultimately, the treatment of multiple myeloma is a complex issue that is best addressed by medical specialists. There are a variety of options available, and you will most likely be receiving multiple modes of treatment, either at the same time or in sequence, to treat your cancer.

Determining Your Eligibility for a Stem Cell Transplant

  1. Understand that a stem cell transplant is another treatment option.A stem cell transplant holds the potential to be a very effective form of treatment, and it can lead to cure from multiple myeloma for about 4% of people (in others, it improves the disease but not to the point of cure). The caveat to stem cell transplants is that, because they are higher risk procedures, there are certain eligibility criteria that must be met in order to receive this treatment.
    • Stem cell transplants are usually autologous, meaning that they use your own cells in order to ensure an exact match. Sometimes another's cells can be used for the transplant, but this is much less common.
  2. Be aware of the eligibility criteria for a stem cell transplant.Due to the higher risk of this treatment, it is up to your doctor's discretion whether he or she recommends to proceed with it. Factors where doctors would likelynotrecommend a stem cell transplant include:
    • Age greater than 77 years old
    • Significant heart problems or heart disease
    • Impaired kidney function
    • Impaired liver function
    • Overall poor health and day-to-day function, as assessed by your physician.
  3. Receive strong chemotherapy prior to the stem cell transplant.You will be given a high dose of chemotherapy treatment prior to the transplant to eliminate as many of the cancer cells as possible from your bone marrow. This is another reason that good health is key in order to undergo this treatment; people with poor health may not be able to tolerate the intense chemotherapy that is required prior to the stem cell transplant. The goal of the chemotherapy is to remove the diseased cells from your bone marrow prior to transplanting healthy ones; if all of the diseased cells are unable to be removed, it puts you at risk of a relapse down the road.
    • If you are going to be cured of multiple myeloma, strong chemotherapy followed by a stem cell transplant is your best bet. Although it can be a challenging procedure to go through, it is likely to be the most effective.
    • Radiation may also be given prior to a stem cell transplant as a further means to get rid of as many cancer cells as possible prior to the transplant.

Community Q&A

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  • Question
    What is involved in a stem cell transplant?

    Family Medicine Physician
    Dr. Matsko is a retired Physician in Pennsylvania. He received his M.D. from the Temple University School of Medicine in 2007.
    Family Medicine Physician
    Expert Answer
    Doctors find a matched donor or use autologous stem cells and harvest them from the (pelvis).The cells are then concentrated. Next, the doctors destroy the recipient's immune system so that the stem cell graft can be accepted into the recipient's body and immune system.
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Date: 06.12.2018, 18:16 / Views: 83464