Treatment for relapsed myeloma
Relapse is the term healthcare professionals use when someone has responded well to treatment, but the condition has come back after a while.
Current myeloma treatments
There are lots of treatments available for people whose myeloma has relapsed even if it relapses multiple times. Whatever combination of drugs your doctors recommend, you will have it over the course of several weeks or months.
You’ll find information about first line treatment on another page. We also have information about the aims and types of myeloma treatment and how they work.
These are the treatments currently approved in the UK for myeloma that has relapsed:
You may be offered one of these treatments if you have had at least one previous treatment for myeloma:
- daratumumab, bortezomib and dexamethasone
- lenalidomide and dexamethasone
- carfilzomib and dexamethasone
- carfilzomib, lenalidomide and dexamethasone
- bortezomib and dexamethasone
- cyclophosphamide, thalidomide and dexamethasone
- ixazomib, lenalidomide and dexamethasone
- pomalidomide and dexamethasone
- lenalidomide on its own
- selinexor with bortezomib and dexamethasone.
If you previously had a stem cell transplant and were in remission for a minimum of 18 months afterwards, you may be offered a second stem cell transplant. Usually, the remission after a second transplant is shorter than after the first one.
You may be offered one of these treatments if you have had at least two previous treatments for myeloma:
- ixazomib, lenalidomide and dexamethasone
- panobinostat, bortezomib and dexamethasone
- pomalidomide and dexamethasone
- selinexor with bortezomib and dexamethasone.
You may be offered one of these treatments if you have had at least three previous treatments for myeloma:
- daratumumab on its own (if you haven't had daratumumab as part of a previous treatment)
- ixazomib, lenalidomide and dexamethasone
- isatuximab, pomalidomide and dexamethasone
- pomalidomide and dexamethasone
- teclistamab.
You may be offered one of these treatments if you have had at least four previous treatments for myeloma:
- pomalidomide and dexamethasone
- panobinostat, bortezomib and dexamethasone
- selinexor and dexamethasone.
"The thing that keeps me positive is that I’ve only done one line of treatment. There's lots of different lines of treatment ahead, and new lines of treatment that make me think someone might actually find a way of curing this stuff."
Craig, living with myeloma since 2020
Find out how Craig and other are coping with a myeloma diagnosis.
How will I take these drugs?
This alphabetical list of myeloma drugs will tell you how they are normally taken.
- If you need a drug that is administered through a drip (intravenous infusion), you will go to hospital as a day patient.
- If you need an injection under the skin (subcutaneous injection) then you have the option of going to hospital as a day patient or learning how to inject yourself – it’s your choice.
- Tablets and capsules can be taken at home.
Given as an injection under the skin or drip into a vein
Given as a drip into a vein.
Taken as tablets
Given as an injection under the skin or drip into a vein
Taken as tablets
Given as a drip into a vein
Taken as capsules
Taken as capsules
Taken as capsules
Taken as tablets
Given as an injection under the skin
Taken as capsules
"When it came back a second time. I must admit, it was tough. And I wasn't really mentally prepared for it. But I'm a big advocate of therapy – it’s the best thing I've ever done."
Sandra, living with myeloma since 2008
Read Sandra's story about myeloma and her mental health
How will my doctor decide what treatment I have?
There are several things your doctor will consider when deciding which treatments to recommend:
- Your overall health and fitness – This includes whether you have any other conditions such as heart problems.
- Genetic test results – information about genetic changes in the myeloma cells in your bone marrow may help your doctor recommend the best treatment for you.
- Your response to previous treatment – your doctor will look at how long you stayed in remission and whether you had significant side effects at the time.
- Practicalities and preferences – Your doctor will also take your personal circumstances into account, such as whether treatment at home or in hospital is better for you, or if you have a preference.
When treatment stops working
Sometimes, myeloma stops responding to treatment. This is called refractory myeloma.
If this happens, your consultant might suggest you take part in a clinical trial which gives you the chance of trying a new treatment.
If you don’t want to take part in a trial, your consultant will discuss other treatment options based on which drugs you’ve already tried, your general health, and your wishes.
When there are no more lines of treatment
There are many lines of treatment for myeloma and more are being researched. But some people will reach a stage where everything has been tried.
If this happens, your doctor will discuss your prognosis with you. The symptoms of the myeloma, such as anaemia, infections or bone pain, will still be treated so you can live as comfortably as possible.
It’s very important to talk through your options with your hospital team. You can also contact our Support Service if you would like support to have this conversation.
Our research impact on myeloma
Together, we're helping to pioneer new treatments for myeloma and improve existing ones.