Initial treatment options

Treatment for myeloma is often most effective when two or more drugs with different but complementary mechanisms of action are given together.

The specific treatment combination will depend on what is most suitable for you and your myeloma and whether you are a candidate for the intensive or less intensive treatment option.

These combinations can include one or more of the following treatment types:

Chemotherapy

Chemotherapy drugs work by damaging the genetic material of cancer cells. They help to destroy the myeloma cells in the bone marrow by preventing them from growing and dividing. Commonly used chemotherapy drugs to treat myeloma include:

• Cyclophosphamide
• Melphalan
• Doxorubicin

Steroids

Steroid drugs are synthetic forms of hormones that are naturally produced by the body. Those used in the treatment of myeloma are called glucocorticoids and include:

• Dexamethasone
• Prednisolone

These steroids can suppress inflammation and the immune response. They may be used alone (monotherapy) but more often are used in combination with one or more other drugs.

Other anti-myeloma treatments

Over the last five to ten years a number of new highly effective drugs have become available and are being used in the initial treatment of myeloma. They work in different ways to standard chemotherapy and therefore when given alongside chemotherapy improve the effect of the treatment combination further preventing the myeloma cells from growing and surviving. Treatments of this type include:

• Thalidomide Celgene® (thalidomide)
• Velcade® (bortezomib)

High-dose therapy and stem cell transplantation

High-dose therapy and stem cell transplantation involves treatment with much higher doses of chemotherapy (usually melphalan) followed by infusion of previously collected stem cells, otherwise known as a stem cell transplant.

This is explained in more detail in the intensive treatment section.

This treatment is very intensive and not everyone will benefit from this treatment option as part of their initial treatment. Factors such as your age and overall health will play an important part in determining whether this may be suitable for you.

 Intensive treatment