After your test results come in, your doctor may want you to have a bone marrow biopsy. He will insert a needle into a bone, usually in your hip, to get a sample of bone marrow to check the number of plasma cells in it.
He may also want you to have X-rays done. They can identify spots of bone weakened by multiple myeloma. Sometimes, a more sensitive CT scan, MRI, or PET scan may be needed.
Treating multiple myeloma usually helps people who already have:
- High blood calcium
- Kidney problems
- Lytic bone lesions
The most effective treatment for multiple myeloma is stem cell transplantation (SCT).
In SCT, some of your stem cells are removed by a machine, frozen, and stored. They may also be taken from a donor.
Next, you may have high-dose chemotherapy. This will destroy almost all the cells in the bone marrow -- both healthy cells and the plasma cells that cause the disease.
The stem cells are then injected into your veins. They travel to the bone marrow, where they multiply and make new, healthy blood cells.
Stem cell transplantation doesn't cure multiple myeloma, but it often helps you live longer.
It’s important for you to know that SCT can cause serious complications, including making you more prone to infections.
Chemotherapy alone doesn't usually work as well as stem cell transplantation for multiple myeloma treatment. But it’s often a good option for people at higher risk for complications from stem cell transplantation.
Doctors usually combine chemotherapy with other drugs to treat the disease. Treatment may include some of these drugs:
- Adriamycin, doxil (Doxorubicin)
- Bendamustine (Treanda)
- Bortezomib (Velcade)
- Carfilzomib (Kyprolis)
- Cyclophosphamide (Cytoxan)
- Ixazomib (Ninlaro)
- Lenalidomide (Revlimid)
- Melphalan (Alkeran)
- Pomalidomide (Pomalyst)
- Thalidomide (Thalomid)
- Vincristine (Oncovin)
Corticosteroids (like dexamethasone or prednisone) are often given with chemotherapy to reduce side effects. Interferon is a hormone-like drug that can help keep the condition in remission after chemo.
Bisphosphonates are drugs used to treat bone damage. Your doctor may suggest pamidronate (Aredia) and zoledronic acid (Zometa), which you'll get through a vein. Be especially good about your dental hygiene while taking these medications. There is a rare risk of deterioration of the jaw. That risk can increase if you get dental work.