Myeloma Treatment

What are the treatment options for myeloma?

The primary treatment options for active myeloma include chemotherapy, immunotherapy, targeted therapies, bone marrow transplant, surgery, and radiotherapy. The type of treatment you receive will depend on a number of different considerations, such as the type of myeloma you have, its stage, your overall health and your treatment preferences. Treatment options may differ between what is used in frontline (previously untreated) myeloma and when myeloma relapses. Multiple lines of therapy may be needed. This page aims to give you a comprehensive overview of how myeloma treatment works.

Radiotherapy for myeloma

Radiotherapy is the primary form of treatment for solitary plasmacytomas and can also be used to treat symptomatic sites of disease in patients with active myeloma. Radiotherapy can improve symptoms of myeloma such as bone pain and slow disease progression. Most people who have radiotherapy for myeloma will receive external radiotherapy.

External beam radiotherapy

External beam radiotherapy is used to treat myeloma by delivering radiotherapy beams to lesions on the bones where cancerous cells and tumours have been detected.

Chemotherapy for myeloma

Chemotherapy uses a range of drugs to kill and slow the growth of multiple myeloma cells. It is typically used to treat active myeloma that is causing symptoms or at risk of damaging organs. Chemotherapy medications vary and may include oral tablets and injectable medications. High dose chemotherapy may also be used which requires the prior collection of your stem cells for recovery after.

Learn more about chemotherapy and how it is delivered.

Chemotherapy treatment for myeloma takes place over several sessions, known as a cycle. Your care team will walk you through how many cycles you may need for your course of treatment and how many days per cycle.

Immunotherapy for myeloma

Immunotherapy treatment uses your own immune system to destroy and slow the growth of myeloma cells. Immunotherapy is typically only used to control active myeloma when symptoms are present. Immunotherapy drugs can also be combined with targeted therapy drugs.

Immunomodulatory therapy

Immunomodulatory drugs are a type of immunotherapy which work by slowing the growth of myeloma cells and by stimulating your immune system cells to identify and kill myeloma cells. They are typically given together in combination with a targeted therapy and a corticosteroid drug and are taken orally as a tablet. 

Targeted therapy for myeloma

Targeted therapies use specialised drugs to destroy specific proteins in myeloma cells. Targeted therapy drugs can also be combined with immunotherapy drugs. 

Bone marrow transplant for myeloma

Bone marrow transplants, also known as autologous stem cell transplants, utilise your own stem cells to rescue the bone marrow and enable recovery after high dose chemotherapy. You will first have your stem cells collected from your blood. Once cells are safely stored you will receive a high dose of chemotherapy. Your own stem cells will then be returned to your blood stream so they will travel to your bones and begin rebuilding healthy bone marrow.

Surgery for myeloma

Surgery is rarely used in the treatment of multiple myeloma, however if your cancer has caused weakened bones, surgery may be used to implant support structures (including metal rods and plates) to prevent and repair fractures.

Treatment by type of myeloma

When you are diagnosed with myeloma, your haematologist will develop your treatment plan as part of a multidisciplinary team based on the type of myeloma you have. Myeloma can sometimes be relatively inactive known as smouldering. This is when the myeloma is not progressing quickly, and it is not causing any damage to organs such as your kidneys or bones. If you do not have any symptoms and your myeloma is smouldering, your haematologist may recommend forgoing treatment in favour of active monitoring. Treating myeloma before you have symptoms, or it becomes active has not been proven to increase life expectancy.

Common treatment options for each type of myeloma include: