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If you're affected by myeloma
What treatments are available?
Treatment for myeloma can be broadly categorised into two groups:
- Less intensive treatment for older and / or less fit patients – standard doses of treatment
- More intensive treatment for younger and / or fitter patients – higher doses of treatment usually followed by a stem cell transplant
The reason for this is that the more intensive treatment brings with it the risk of increased side-effects and complications which could be particularly risky for older and / or less fit patients.
Less intensive treatment
This includes drugs with different methods of action which are commonly used in combination including cyclophosphamide, thalidomide and dexamethasone (CTDa), melphalan, prednisolone and thalidomide (MPT). The 'a' in the CTD combination denotes attenuated which means lower doses of some, if not all, of the drugs.
These combinations include a chemotherapy drug (cyclophosphamide / melphalan), a steroid (dexamethasone / prednisolone) and another kind of anti-cancer drug known as an immunomodulatory drug (thalidomide).
Another combination treatment used to treat newly diagnosed myeloma patients who do not plan on having a stem cell transplant is Velcade® (bortezomib), melphalan and prednisolone (VMP). Velcade® is a relatively new kind of anti-myeloma drug called a proteasome inhibitor; melphalan is a chemotherapy drug similar to cyclophosphamide and prednisolone is a steroid similar to dexamethasone.
Intensive treatment
Younger and / or fitter patients will be treated with a combination of drugs as part of their initial treatment but this will almost always be followed by what is called high-dose therapy and stem cell transplantation. This means that specific blood cells called stem cells are collected and stored prior to the administration of very high doses of chemotherapy. The doses of chemotherapy are so high that it kills all the remaining bone marrow and the re-infusion of the healthy stem cells is required to keep the patient alive until their bone marrow recovers normal blood cell production.
Further information about high-dose therapy and stem cell transplantation can be found here – link to HDT SCT Infoguide.
There are also a number of important and effective supportive care treatments and procedures to help treat the symptoms and complications of myeloma including:
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Information
For more information see our series of Infoguides, Infosheets and videos.
