Multiple Myeloma Treatment
If you are diagnosed with multiple myeloma, your doctor will discuss the best options to treat it. This depends on several factors, including the type and stage of the cancer and your general health.
Your treatment for multiple myeloma will be customized to your particular needs. One or more of the following therapies may be recommended to treat multiple myeloma or help relieve symptoms.
Watchful waiting
For patients with asymptomatic (smoldering) myeloma or monoclonal gammopathy of undetermined significance (MGUS), a watchful waiting approach may be appropriate. The watchful waiting approach involves closely monitoring multiple myeloma without active treatment.
Chemotherapy
Chemotherapy is the usual starting point in treating multiple myeloma. It uses special drugs that kill fast-growing cells, like multiple myeloma cells. MD Anderson offers the most up-to-date and advanced chemotherapy options.
Targeted therapy
MD Anderson is among just a few cancer centers in the nation that are able to offer targeted therapies for some types of multiple myeloma. Targeted therapy is a broad term used to describe drugs that specifically target weaknesses of the cancer cells. This can mean targeting the blood vessels that feed tumors or attacking specific genetic and proteins of cancer. Ultimately, by targeting the weaknesses of cancer, these treatments help stop its growth and spread.
Immunotherapy
Immunotherapy is one of several innovative targeted therapies performed by MDAnderson. It uses your own immune cells to fight off cancer cells. Usually, the immune system does not attack cancer cells because they produce special proteins that help them blend in with other cells. Immunotherapy drugs interfere with the production of these proteins, triggering an immune response to fight off your cancer. There are a few different methods used for immunotherapy, including:
- Monoclonal antibodies, including Darzalex (daratumumab) and Empliciti (elotuzumab)
- Chimeric antigen receptor (CAR) T cells, which are genetically modified T cells that fight the myeloma directly
- Bispecific t cell engagers, which help activate and get your own immune cells next to myeloma cells in your body to kill them
- Cytokine therapies
- Vaccine therapy
Radiation therapy
Radiation therapy often plays a valuable role in providing quick pain relief and decreasing the risk of fractured bones. It involves using a high-energy beam to quickly kill cancer cells in a specific area. Radiation therapy can help prevent nerve compressions by attacking soft tissue collections of myeloma cells (plasmacytomas). It is also useful for targeting plasma cell tumors present in one location (solitary plasmacytoma). In these situations, radiation therapy alone is often used as the primary treatment.
A typical radiation treatment plan for a patient with multiple myeloma includes five sessions a week for approximately two weeks. We use computed tomography (CT) scan based radiation planning, immobilization devices to minimize patient movement during treatment, and modern radiation planning techniques that permit focused radiation delivery. Our Radiation Oncology Center treats more than 100 multiple myeloma and plasmacytoma patients each year, with a team of four skilled radiation oncologists who specialize in the management of patients with hematologic malignancies. Our ultimate goal is to administer effective, safe, modern radiation therapy while limiting toxicity.
Stem cell transplants
A stem cell transplant (or bone marrow transplant) replaces defective or damaged bone marrow cells with your own healthy blood-forming cells. First, your doctor will remove some of your healthy, blood-forming stem cells. Then, you will receive high-dose chemotherapy to kill off the diseased bone marrow cells. Finally, your healthy blood-forming stem cells will be transplanted in place of the diseased tissue. If a stem cell transplant is needed, MD Anderson has one of the most active and advanced programs in the nation.
Plasma exchange
High levels of abnormal proteins can lead to thickening of the blood. The liquid component of your blood, called the plasma, can be removed and replaced with normal plasma from a healthy donor. This can quickly relieve symptoms of increased blood thickness (hyperviscosity) until chemotherapy/immunotherapy has a chance to destroy the multiple myeloma cells that produce the abnormal protein.
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