Treating Multiple Myeloma

Since multiple myeloma is a systemic disease (it affects the entire body) one of the most commonly used treatment option is chemotherapy.

Multiple Myeloma Drug Guide

Multiple Myeloma Treatment Guide

Overview of treatment drugs (from WebMD)

Chemotherapy Drugs
From Lifescript, page 6, examples of chemotherapy drugs used for multiple myeloma include:

Bortezomib (Velcade)
Cyclophosphamide (Cytoxan)
Dexamethasone (Decadron)
Doxorubicin (Adriamycin)
Lenalidomide (Revlimid)
Melphalan (Alkeran)
Thalidomide (Thalomid)
Vincristine (Oncovin)
Combination therapy
Melphalan and prednisone
Vincristine, doxorubicin, and dexamethasone


Usually given as an injection.

Understanding Velcade (Bortezomib)

Bortezomib (Velcade) including side effects

Video Understanding Velcade Subcutaneous (from the IMF) (8:25 minutes)

Understanding your treatment: Velcade therapy (24:02 minutes)

Velcade Animation with Narration (1:40 minutes)


Dexamethasone (steroid)

"The mental side effects dexamethsone can cause is fairly long and includes depression, emotional instability, euphoria, headache, intracranial pressure increased, insomnia, malaise, mood swings, neuritis, personality changes, pseudotumor cerebri (usually following discontinuation), psychic disorders, seizure, vertigo... (from the Myeloma Beacon)

Dexamethasone can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had.

Do not stop using dexamethasone suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Drink 6-8 cups of fluids every day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).

Dexamethasone (from UPMC)

Dexamethasone for Myeloma Treatment

Side effects and more information about Dexamethasone and steroids

Pub Med Health

Myeloma 101: Dexamethasone and Blood Sugar Levels (from Myeloma Crowd)

Dexamethasone Forum From brain cancer forum, with stories of the effects of Dexamethasone


Lenalidomide (Revlimid)

Revlimid is used as a common treatment for multiple myeloma. It is an expensive drug and the patient needs to answer telephone questions about the safe practice of using Revlimid. The phone number to call to answer the questions is: 1-888-423-5436

Information about the Celgene Risk Management

Information from Celgene on Revlimid

Lenalidomide (Revlimid) information and side effects

Revlimid Side Effects

Revlimid Side Effects Center (with a Revlimid / placebo comparison chart)

Lenalidomide and the Risk for Second Cancers in Myeloma (after using melphalan)

Video Understanding your treatment: Revlimid therapy (24:16 minutes)

Revlimid an overview (1:29 minutes)

Cytoxan (Cyclophosphamide)

Cytoxan is a commonly used drug for treating multiple myeloma.




Acyclovir is used to prevent shingles during chemotherapy treatment.

Acyclovir (from WebMD)

What Is Acyclovir (Zovirax)?



Daratumumab / lenalidomide / dexamethasone

Immunotherapy Benefits Patients with Drug-Resistant Multiple Myeloma, from Cancer Connect

Video Dr. Torben Plesner on daratumumab/lenalidomide/dexamethasone in RRMM (ASH 2014) (IMF) (4:21 minutes)

Drug Combinations

Often drugs are administrated in combination for greater effectiveness. These are given abbreviations that reflect the combination, such as:

CyBorD for Cytoxan with Bortezomib (Velcade) and Dexamethasone

RevD for Revlimid and Dexamethasone

Lenalidomide Plus Dex Trumps Standard Tx in Multiple Myeloma

Newer drug treatments for patients that have had at least one other treatment

Ninlaro (Ixazomib)

FDA Approves Ninlaro for Multiple Myeloma

Ninlaro information and side effects
Ninlaro information
What is Ninlaro? (From the Multiple Myeloma Research Foundation - see detailed links on the left of their Web page)
Ninlaro clinical trials (From the Multiple Myeloma Research Foundation)

Ninlaro (From

Kyprolis (Carfilzomib)

Kyprolis is used for relapsed multiple myeloma
Delivered by an intravenous infusion (IV)

Information about Kyprolis and side effects (

There are a number of side effects when using kyprolis and the patient should be aware of them

Kyprolis from, dosage, side effects

Kyprolis from the Multiple Myeloma Research Foundation

Empliciti (Elotuzumab)

Delivered by an intravenous infusion (IV)


FDA Approves Empliciti for Multiple Myeloma (from Cure)

Clinical trial results (from the Myeloma Beacon)

Empliciti from

Managing Side Effects

Video Managing Side Effects from the International Myeloma Foundation (39.42 minutes)


Recovery after intensive treatment for myeloma

Auto Stem Cell Transplant or autologous stem cell transplant

Auto Stem Cell Transplant or autologous stem cell transplant using a patient's own stem cells


1. Harvesting stem cells

Neupogen (filgrastim) is a man-made form of a protein that stimulates the growth of white blood cells in your body

Inject Neupogen (Filgrastim)
White cell count goes from about 5 million to 50 million
Since it is a soft bone, you may feel pain in the sternum or breastbone is a long flat bone shaped like a necktie located in the center of the chest. This may appear as a heart attack. Call your hospital or clinic if you are concerned.

Neupogen Side Effects

The patient is connected to a centrifuge, non-dominant arm is usually used to take blood out, and cannot be moved once the procedure starts

Blood is put back into the other arm, which may be moved, use to control a music player or remote, etc.

If you feel cold, may need to turn on a blood warmer on the machine, or get a blanket.

2. Transplant process

Uses Melphalan to kill the cells in the bone marrow, including the myeloma cells.
Then the patient's stem cells are infused back into the patient’s blood.

Some doctors recommend a tandem transplant of 2 autologous transplants, 6 to 12 months apart. This approach is called a tandem transplant.

A patient may be on maintenance drugs after the transplant, but not everyone is on maintenance drugs

A patient may feel weak for a number of months

What Is Autologous Stem Cell Transplantation?

Transplant: Do you need one?

Stem cell transplant for multiple myeloma

Melphalan (Wikipedia)

Melphalan (Chemocare)

Multiple Myeloma and Melphalan

Secondary Cancers after Melphalan
Revlimid And Secondary Cancers: Melphalan May Be The Culprit

BMT (Blood & Marrow Transplant) Information Network

Blogs and Links

Living With Multiple Myeloma

Dexamethasone Support Group from

Treto (general, not specific to multiple myeloma)

The myeloma drug quiz

Financial Help for Cancer Patients