Multiple Myeloma Treatment

At MD Anderson, we offer multiple myeloma patients the most advanced treatments along with a range of clinical trials (research studies) of newer drugs and therapies. Our myeloma experts work closely together and with you to develop the most effective treatment plan, while focusing on your quality of life.

While treatments usually do not cure multiple myeloma, we can improve the quality of life and health of many patients by decreasing the disease and its symptoms for extended periods.

Advanced Treatment Options

The standard approach to newly diagnosed multiple myeloma is frontline chemotherapy for a few months, followed by high dose chemotherapy and a stem cell transplant (also known as stem cell rescue), then maintenance therapy, which entails lower doses of chemotherapy. MD Anderson is among a select few centers that are pioneering newer options which will hopefully improve outcomes. Many patients have had remarkable success.

These options include immunotherapy to help your body fight the cancer and new methods for stem cell transplantation. In addition, we are actively pursuing ways to reduce the symptoms and side effects of multiple myeloma and its treatments. For instance, we were instrumental in finding that multiple myeloma patients taking bisphosphates are less likely to have bone-related events, such as breaks.

Multiple Myeloma Treatments

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 the cancer or help relieve symptoms.

Multiple myeloma chemotherapy

Chemotherapy is the usual starting point in treating multiple myeloma. MD Anderson offers the most up-to-date and advanced chemotherapy options. 

Immunotherapy

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. These innovative new drugs stop the growth of cancer cells by interfering with certain proteins and receptors or blood vessels that supply the cancer with what it needs to grow.

Possibilities may include:

• Monoclonal antibodies, including Darzalex (daratumumab) and Empliciti (elotuzumab)
• Chimeric antigen rector T cells (CAR T cells) which are genetically modified T cells which 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

Multiple myeloma radiation therapy

Radiation therapy often plays a valuable role in providing quick pain relief and decreasing the risk of fractured bones. It can also attack soft tissue collections of myeloma cells (plasmacytomas) that may threaten neurologic function by compressing the spinal cord or various nerves. In rarer instances, plasma cell tumors will 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. Despite the lower doses of radiation therapy that are utilized to treat patients with multiple myeloma, it is still essential that radiation therapy is administered in a targeted way to minimize radiation exposure to surrounding normal tissues. This is accomplished through the utilization of 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, such as intensity modulated radiation therapy (IMRT), volumetric arc radiation therapy (VMAT) and proton radiotherapy.

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. 

Multiple myeloma stem cell transplants

A stem cell transplant replaces defective or damaged cells in patients whose normal blood cells have been affected by cancer. If a stem cell transplant is needed, MD Anderson has one of the most active and advanced programs in the nation. 

Multiple myeloma plasma exchange

High levels of abnormal proteins can lead to thickening of the blood. Plasma can be removed and replaced with normal plasma from a healthy donor. This can quickly relieve symptoms of increased blood thickness until chemotherapy/immunotherapy has a chance to destroy the multiple myeloma cells that produce the abnormal protein.

Watchful Waiting

The watchful waiting approach involves closely monitoring multiple myeloma without active treatment. It is recommended for patients with asymptomatic (smoldering) myeloma or monoclonal gammopathy of undetermined significance (MGUS).