Multiple Myeloma

Treatment

If a patient has a stable form of multiple myeloma, called "smoldering myeloma," the hematologist may recommend no treatment. However, if the multiple myeloma is not stable, the patient will require immediate treatment. The treatment depends on the patient's needs, medical history and general health.

One treatment for myeloma is chemotherapy. Chemotherapy is used to kill cancer cells. It may include pills or intravenous (given directly into a vein) medications. Radiation therapy (high-energy, penetrating X-rays) may also be given.

If a patient undergoes chemotherapy, the number of myeloma cells in the bone marrow and the amount of monoclonal protein in the blood and urine will be closely monitored. This information helps the physician monitor the patient's progress and make any needed adjustments to the treatment. A decrease in the monoclonal protein level usually means that the treatment is working. A stable monoclonal protein level indicates that the disease is stable, often the result of effective treatment. The monoclonal protein rarely disappears completely from blood and urine.

Other possible treatments include peripheral stem cell transplantation. Peripheral stem cell transplantation involves the use of high-dose chemotherapy or radiation therapy and the transfusion of previously collected immature, or "young," blood cells to replace diseased or damaged marrow. The proper role for peripheral stem cell transplantation in treating multiple myeloma is being investigated. People must meet specific medical requirements to be considered for this treatment.

Some people with multiple myeloma find physical therapy, relaxation training, physical medicine treatments and counseling helpful in coping with myeloma pain.

Although myeloma cannot be cured, it may be controlled with treatment. With good treatment results, the patient usually can return to near-normal activity. Some restrictions, such as avoiding heavy lifting, may still be necessary. New treatments for multiple myeloma are constantly being studied at Mayo Clinic. (See clinical trials.)