Myeloma treatment and side effects
Myeloma treatment types
There are many drugs approved to treat myeloma and you will normally have a combination of different ones that work in different ways to kill the myeloma cells.
Treatments for myeloma have changed a lot in the last few years and there’s been a general move towards targeted treatments that are less toxic to healthy cells. Read more about our research on myeloma.
On this page:
Inhibitors (cancer growth blockers)
Inhibitors are targeted drugs which block the signals that make cancer cells grow. Inhibitors used to treat myeloma include bortezomib, carfilzomib, ixazomib and panobinostat.
Monoclonal antibodies (immunotherapy)
Monoclonal antibodies are targeted drugs which bind to and kill specific cells. Daratumumab and isatuximab are monoclonal antibodies that are effective at killing myeloma cells.
Other targeted drugs
Thalidomide, lenalidomide and pomalidomide are immunomodulatory drugs – targeted drugs which stop myeloma cells growing and help your own immune system to attack myeloma cells.
It’s essential to use a barrier method of contraception to avoid getting pregnant if you or a sexual partner are taking thalidomide, lenalidomide or pomalidomide. This is because these drugs have been known to affect the development of unborn babies.
These drugs also increase your chance of developing blood clots, which can block blood vessels and lead to deep vein thrombosis, pulmonary embolism (clots in the lungs), heart attack or stroke. So you may be given medication to thin your blood. These include aspirin, low molecular weight heparin (LMWH), or newer medications such as apixaban. LMWH is injected daily under the skin, and aspirin and apixaban are taken as a tablet.
Chemotherapy drugs work by stopping myeloma cells dividing and growing. Cyclophosphamide and melphalan are chemotherapy drugs used to treat myeloma.
"It looks like a giant mountain in front of you that you've got to climb. But you've got to just take it one step at a time. That’s what helped me get through it."
Cecelia, living with myeloma since 2020
Read how Cecelia and other are coping with a myeloma diagnosis.
Steroids help to kill myeloma cells and work together with other drugs. They also reduce swelling (inflammation). Dexamethasone and prednisolone are steroids used to treat myeloma.
Stem cell transplant
All the cells in our body come from parent cells called stem cells. A blood stem cell transplant aims to put healthy stem cells back into your body so you can start producing normal blood cells.
There are two main types of stem cell transplant:
- auto (autologous or autograft) – this uses your own stem cells
- allo (allogeneic or allograft) – this uses stem cells from a donor.
People with myeloma typically have auto transplants. Occasionally allo stem cell transplants might be considered for fitter people with a particularly fast-growing type of myeloma.
An auto transplant is a way of giving stronger chemotherapy to keep you in remission for longer. The aim is to kill any myeloma cells that are left.
If your doctors think an auto transplant may be right for you, healthy stem cells will be harvested from your bloodstream once you are in remission. It’s likely that you’ll have a chemotherapy drug called melphalan to kill the remaining myeloma cells before your stem cells are returned to your body.
For more information about stem cell transplants, download or order our booklet: The seven steps: blood stem cell and bone marrow transplants.
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