Chemotherapy for Multiple Myeloma

by Michael Jubinville, MPH

Chemotherapy (chemo) uses drugs to kill cancer cells. The drugs are passed through the blood and travel through the body. It is mainly used to ease symptoms caused by multiple myeloma (MM) and prolong life. Chemo phases are:

Induction —To lower the amount of cancer cells in the body.
Consolidation —To kill any leftover cancer cells still in the body. It is done before a stem cell transplant.
Maintenance —Extends the time when the disease is not active to prolong life.

Chemotherapy Drugs and Delivery

There are many kinds of drugs that can be used. Chemo is most often given through an IV. It may be combined with other types of drugs designed to target the cancer cells or with corticosteroids to ease side effects. The care team will help to find the best combination for each person. The most common drugs are:

Thalidomide
Pomalidomide
Lenalidomide
Doxorubicin
Cyclophosphamide
Melphalan
Vincristine

Side Effects and Management

Chemo is made to target cancer cells. However, it can also affect fast growing healthy cells. This can cause a range of health problems. The most common are:

Nausea and vomiting
Feeling tired or sleepy
Hair loss
Anemia
Infections happen more often or last longer than normal
Bleeding
Constipation
Diarrhea
Tingling, numbness, pain, or weakness—peripheral neuropathy
Fertility problems (rare)—If you plan on having children, talk to your doctor about preserving fertility before getting treated.

There are many ways to manage these problems. Medicines and lifestyle changes are the most common. In some cases, the cycles may be changed to lower the chances of serious problems. Talk to your care team as soon as these appear so they can be better controlled.

References:

Chemotherapy and other drugs for multiple myeloma. American Cancer Society website. Available at: https://www.cancer.org/cancer/multiple-myeloma/treating/chemotherapy.html. Updated January 3, 2019. Accessed May 6, 2019.

Michels TC, Petersen KE. Multiple myeloma: Diagnosis and treatment. Am Fam Physician. 2017;95(6):373-383A.

Multiple myeloma. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T116888/Multiple-myeloma. Updated March 29, 2019. Accessed May 6, 2019.

Multiple myeloma. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/hematology-and-oncology/plasma-cell-disorders/multiple-myeloma. Updated May 2018. Accessed May 6, 2019.

Toxicities of chemotherapeutic agents. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated July 31, 2018. Accessed May 6, 2019.

Treatment options for plasma cell neoplasms. National Cancer Institute website. Available at: https://www.cancer.gov/types/myeloma/patient/myeloma-treatment-pdq#_46. Updated April 9, 2019. Accessed May 6, 2019.

Last reviewed March 2019 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 5/6/2019

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