Treatment for myeloma is highly individual and depends on several factors, such as the type and stage of myeloma, your symptoms and your general health. As myeloma is not curable, the aim is to get the myeloma under control and maintain control for as long as possible.
Learn more about:
- Treatment options
- Combining drug therapies
- Proteasome inhibitors and monoclonal antibodies
- Stem cell transplant
- Supportive treatment
- People who have been diagnosed with either monoclonal gammopathy of undetermined significance (MGUS) or smouldering myeloma usually do not need treatment straightaway.
- Most people with MGUS never develop active myeloma. In most cases of smouldering myeloma, having treatment straightaway does not offer any benefits, but a small number of people with high-risk smouldering myeloma may benefit from early therapy.
- If tests show you have MGUS or smouldering myeloma, you will need check-ups every 3–12 months. This is called active monitoring. Your doctor will start treatment if you develop symptoms or other significant signs of myeloma.
Treatment to control active or symptomatic myeloma
- This is often called induction or first-line treatment.
- It includes a combination of different drugs.
- A stem cell transplant may be suggested for some people.
- Active treatment may be followed by periods of stable disease (plateau phase or remission) when no maintenance therapy or treatment is needed.
Treatment for the symptoms and side effects of myeloma
- These treatments help manage issues associated with myeloma, such as bone disease, pain, kidney damage, hypercalcaemia, frequent infections and fatigue.
Treatment to prevent the disease returning
- This is called maintenance or consolidation therapy.
- It involves a longer, lower- dose course of an immunomodulator such as lenalidomide, steroids and/or other drugs. It is often used after a stem cell transplant and sometimes after other first-line treatment.
Treatment when the disease comes back
- You may be offered a different type of chemotherapy, a stem cell transplant, steroids or other drugs to regain control of the disease.
Combining drug therapies
Most people with myeloma will be treated with a combination of two, three or more different drugs.
Combinations of drugs are used because each type of drug works differently to kill myeloma cells, and the combined effect helps treat as much of the disease as possible.
The choice of a particular combination will depend on the type of myeloma, your age and your kidney function. Your haematologist will select the most suitable combination and discuss this with you.
Prof John Gibson, Haematologist, Institute of Haematology, Royal Prince Alfred Hospital and The University of Sydney, NSW; Dr Stephanie Anderson, Registrar, Institute of Haematology, Royal Prince Alfred Hospital, NSW; Tanya Carney, Consumer; Jacqui Keogh, NSW State Manager/Senior Myeloma Nurse NSW, Myeloma Australia; Dr Silvia Ling, Haematologist, Liverpool Hospital, NSW; Rachel McCann, Myeloma Support Nurse NSW, Myeloma Australia; John McMath, Consumer; Karen Robinson, 13 11 20 Consultant, Cancer Council NSW.
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