Plasma cell dyscrasia; Plasma cell myeloma; Malignant plasmacytoma; Plasmacytoma of bone; Myeloma - multiple

The goal of treatment is to relieve symptoms, avoid complications, and prolong life.

People who have mild disease or where the diagnosis is not certain are usually carefully watched without treatment. Some people have a slow-developing form of multiple myeloma that takes years to cause symptoms.

Medications for the treatment of multiple myeloma include:

• Dexamethasone, melphalan, thalidomide, lenalidomide (Revlimid), and bortezomib (Velcade) can be used alone or together.
• Drugs called bisphosphonates (pamidronate) are used to reduce bone pain and prevent fractures.

Radiation therapy may be performed to relieve bone pain or treat a bone tumor.

Two types of bone marrow transplantation may be tried:

• Autologous bone marrow or stem cell transplantation makes use of one’s own stem cells. In younger patients, it has been shown to increase survival.
• Allogeneic transplant makes use of someone else’s stem cells. This treatment carries serious risks.

People with multiple myeloma should drink plenty of fluids to prevent dehydration and help maintain proper kidney function. They should also be cautious when having x-ray tests that use contrast dye.

The stress of illness may be eased by joining a support group whose members share common experiences and problems. See: Cancer - support group

Survival of people with multiple myeloma depends on the patient's age and the stage of disease. Some cases are very aggressive, while others take years to get worse.

Chemotherapy and transplants rarely lead to a permanent cure.

Kidney failure is a frequent complication. Other complications may include:

• Bone fractures
• High levels of calcium in the blood, which can be very dangerous
• Increased chances for infection (especially pneumonia)
• Paralysis from tumor or spinal cord compression

Call your doctor if you have multiple myeloma and infection develops, or numbness, loss of movement, or loss of sensation develops.

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Review Date: 03/02/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)