Multiple Myeloma

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Treatments for Complications

Myeloma can affect your body in many ways. In addition to getting treatment to control the myeloma, you may also need treatment for complications of the disease, such as these:

  • Increased risk of infection (due to low white blood cells), anemia (due to low red blood cells) and blood-clotting problems (due to low platelets)
  • Lowered immune function because myeloma cells don’t make effective antibodies 
  • Weakened bones, and possibly pain and fractures, due to myeloma activity
  • High blood calcium because of dissolving bone
  • Kidney damage from high blood calcium and from proteins released by myeloma cells
  • Circulation problems because the abnormal proteins tend to stick to each other and to other tissues

Here are several of the most common treatments for myeloma complications:

  • Infection treatments—If your immune system is weak because your white blood cell levels are low, you may be prone to infections, like pneumonia. So you may need antibiotics to fight an infection or another medicine, called filgrastim (Neupogen), to boost your white blood cells.
  • Erythropoietin—This drug also goes by the brand names Procrit and Aranesp. It can be given to help boost your red blood cells if you have anemia. Anemia can make you feel weak and tired. For more severe anemia, you may need a transfusion. This means receiving red blood cells through an intravenous (IV) line.
  • Drugs to manage calcium levels—Drugs called bisphosphonates help reduce destruction of bone. So they help reduce the calcium levels in your blood and stabilize your bones. They can also help relieve bone pain. (You can use pain medications to relieve bone pain, too.) Two common bisphosphonates are called zoledronate (Zometa) and pamidronate (Aredia).
  • Orthopedic surgery—Your doctor may suggest surgery to place metal rods or plates to repair or strengthen bones damaged by myeloma. If vertebrae in your spine are damaged, they may press on your spinal cord or the nerves that branch from your spinal cord to the rest of your body. In this case, you may need emergency surgery to take off the pressure.
  • Hemodialysis—If your kidneys don’t work well, you may need hemodialysis. In this process, a tube connected to one of your veins drains blood from your body to a machine. The machine filters wastes from your blood. Then the blood is returned to your body through another tube in your vein. Diuretics, drugs that increase urination, can also help relieve the burden on your kidneys.
  • Plasmapheresis—This process removes excess protein from your blood in order to thin the blood and help prevent stroke. A tube connected to one of your veins drains blood from your body into a machine. The machine separates the plasma (the liquid part of blood) from the blood cells (white and red blood cells and platelets). The plasma, which carries the harmful excess protein, is discarded. Then your blood cells are mixed with salt solution and normal proteins from donors. This blood is returned to your body through another tube going into a different vein.