The most common treatment to control myeloma cells is chemotherapy, often followed by a bone marrow transplant and then long-term maintenance therapy in the form of low-dose chemo.
Deciding on chemotherapy
Several chemotherapy medicines and combinations are available for treating myeloma. It may be easier or harder to tolerate the side effects of some compared to others. Some tend to work more quickly or slowly than others. These issues may influence the plan your doctor recommends.
Another important consideration is that some chemotherapy medicines are more likely to damage your stem cells. If you have these medicines, a transplant will not be as good an option for you in the future. So before deciding about your chemotherapy, you and your doctor will want to talk about a transplant.
- If you are a good candidate, your doctor will most likely recommend having a transplant, and this will affect their recommendations about chemotherapy.
- If you are not a good candidate for a transplant, your doctor will likely recommend chemotherapy alone or with radiation therapy.
Some people who intend to have chemotherapy without a transplant may arrange to have their stem cells removed and stored for a possible transplant in the future. Talk with your doctor to see if this makes sense in your situation.
Common forms of chemotherapy
Common forms of chemotherapy for myeloma include:
- Dexamethasone (steroids) alone or with other medicines
- Melphalan (Alkeran) and prednisone (a combination also called MP)
- Cyclophosphamide (Cytoxan) and prednisone (a combination called CP)
- Lenalidomide (Revlimid) and dexamethasone (a combination also called Rev-Dex or Rd)
- Bortezomib (Velcade), alone or with other medicines
- Carfilzomib (Kyprolis), alone or with other medicines
- Panobinostat (Farydak) in combination with other medicines
- Elotuzumab (Empliciti) in combination with other medicines
- Daratumumab (Darzalex) in combination with other medicines
Your SCCA team will talk with you about the specific medicines we recommend for you, how you’ll receive them, your treatment schedule and what to expect. We’ll also explain how to take the best possible care of yourself during treatment and after, and connect you with medical and support resources throughout SCCA. Most people with multiple myeloma tolerate chemotherapy well and continue to work, raise their families or enjoy their retirement while on therapy.