How is multiple myeloma treated?
In the absence of symptoms (smoldering multiple myeloma)
No treatment is required at this stage. Regular follow up is advised to monitor the progress of the disease. If you develop signs and symptoms or your multiple myeloma shows signs of progression, you and your doctor may decide to begin treatment.
In the presence of symptoms
Treatment options for multiple myeloma depend on the stage and severity of the disease. A combination of more than one treatment modality may be advised. Treatment options include
- Targeted therapy: Targeted drug treatment focuses on specific abnormalities within cancer cells. The targeted drugs like monoclonal antibodies bind to specific proteins in cancer cells causing them to die. They may be administered intravenously or orally.
- Biological therapy: Biological therapy drugs involve using the body's immune system to fight against myeloma cells. They stimulate the immune system cells to identify and attack cancer cells. These medications are usually taken orally
- Chemotherapy: Chemotherapy drugs kill fast-growing cells, including myeloma cells. They may be administered intravenously or orally.
- Corticosteroids: Corticosteroids, such as prednisone and dexamethasone, suppress the immune system and reduce inflammation in the body. Corticosteroid may be administered orally form or intravenously.
- Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, is a minimally invasive procedure to replace the diseased bone marrow with healthy bone marrow.
- Radiation therapy: This treatment uses beams of radiation energy, such as X-rays, to target and kill myeloma cells.
Treatment of complications
multiple myeloma can cause a number of complications which also need treatment:
- Bone pain: Pain medications, radiation therapy or surgery may help reduce bone pain.
- Kidney complications: Patients with severe kidney damage may need dialysis.
- Infections: antibiotics may be prescribed to treat infections. vaccines to prevent infections, such as the flu and pneumonia may be administered.
- Bone loss: medications called bisphosphonates, can help prevent bone loss.
- Anemia: medications to increase red blood cell count may be prescribed
- Secondary cancers due to the drugs used in chemotherapy also remains a concern and should be watched out for.
What is multiple myeloma?
Multiple myeloma is a cancer of the plasma cells. The plasma cells are a type of white blood cells present in the bone marrow. Plasma cells are part of the immune system and help fight against infections by producing antibodies that recognize and attack microorganisms. Multiple myeloma causes cancer cells to accumulate in the bone marrow and replace healthy blood cells. The cancerous plasma cells multiply rapidly and do not function normally. Instead of producing beneficial antibodies, the cancer cells produce abnormal proteins called Monoclonal protein or M protein, which cause complications. Multiple myeloma can eventually damage the bones, immune system, kidneys, and red blood cells. There may not be any symptoms initially or the symptoms may be generalized and non-specific, such as loss of appetite, bone pain, and fever. Multiple myeloma is the second most common type of blood cancer after leukemia.
What causes multiple myeloma?
The exact cause of multiple is not known but certain factors can increase the risk of multiple myeloma:
- Increasing age: The risk of multiple myeloma increases after the age of 60.
- Male sex
- Black race
- Family history of multiple myeloma.
- Personal history of a monoclonal gammopathy of undetermined significance (MGUS): Multiple myeloma can as a relatively benign condition called monoclonal gammopathy of undetermined significance (MGUS) which is characterised by elevated levels of abnormal protein called M protein, same as in multiple myeloma.
What are the signs and symptoms of multiple myeloma?
Common signs and symptoms include:
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Darzalex Faspro (daratumumab and hyaluronidase-fihj)Darzalex Faspro (daratumumab and hyaluronidase-fihj) is a prescription medicine used to treat adults with multiple myeloma, which may be used alone or in combination with other medications. Serious side effects of Darzalex Faspro serious allergic reactions include serious allergic reactions, injection site reactions, decreases in blood cell counts, and changes in blood tests.
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Ninlaro (ixazomib)Ninlaro (ixazomib) is a prescription medicine used to treat multiple myeloma in combination with the medicines Revlimid (lenalidomide) and dexamethasone, in people who have received at least one prior treatment for their multiple myeloma.
Pepaxto (melphalan flufenamide)Pepaxto is a prescription medicine used in combination with the medicine dexamethasone to treat adults with multiple myeloma who did not respond to or stopped responding to at least four prior medicines including at least one proteasome inhibitor, one immunomodulatory agent and one CD38-directed antibody. Serious side effects of Pepaxto include low blood cell counts, infections, and secondary cancers.
Pomalyst (pomalidomide)Pomalyst is a prescription medicine used to treat adults with multiple myeloma, AIDS-related Kaposi sarcoma (KS), and non-AIDS-related Kaposi sarcoma (KS). Serious side effects include severe birth defects and miscarriage when taken in pregnancy, venous and arterial thromboembolism, low white blood cells (neutropenia), low platelets (thrombocytopenia), low red blood cells (anemia), severe liver problems, and Severe allergic reactions and severe skin reactions.
Xpovio (selinexor)Xpovio is a prescription medicine used in combination with dexamethasone to treat adults with multiple myeloma (MM), and to treat adults with certain types of diffuse large B-cell lymphoma (DLBCL). Xpovio can cause serious side effects, including nausea and vomiting, diarrhea, loss of appetite and weight loss, decreased sodium levels in your blood, serious infections, and neurologic side effects.