NCCN Guidelines for Patients® | Multiple Myeloma - page 47

47
NCCN Guidelines for Patients™: Multiple Myeloma
Version 1.2012
Par t 8
Par t 7
Par t 6
Par t 5
Par t 4
Par t 3
Par t 2
Par t 1
5.4 Active multiple myeloma
Part 5.4.1 describes treatment for active myeloma that can’t be treated with a stem cell
transplant. Primary treatment includes chemotherapy, targeted therapy, and steroids given
alone or in combination. Compared to ‘other’ regimens, ‘preferred’ regimens work better,
have less serious side effects, or both. After two cycles of primary treatment, you will have
follow-up tests to check your response to treatment.
Along with primary treatment, adjunctive treatment is recommended. Bone damage from
myeloma is very common, so bisphosphonates are recommended. If your primary treatment
consists of thalidomide or lenalidomide, blood thinners are suggested. Other adjunctive
treatment is given as symptoms of myeloma or treatment appear.
Next steps:
See Part 5.4.2 for a list of follow-up tests after primary treatment for active myeloma.
5.4.1 Primary treatment alone (no transplant)
Adjunctive treatment
Primary treatment
Preferred regimens
Bortezomib/dexamethasone,
Lenalidomide/low-dose dexamethasone,
Melphalan/prednisone/bortezomib,
Melphalan/prednisone/lenalidomide, or
Melphalan/prednisone/thalidomide
Other regimens
Dexamethasone,
Liposomal doxorubicin/vincristine/
dexamethasone,
Melphalan/prednisone, or
Thalidomide/dexamethasone
Bisphosphonates for bone health
As needed:
Control of bone pain with drugs, radiation
therapy, or surgery,
Drug treatment for high calcium levels,
Plasmapheresis for hyperviscosity,
Erythropoietin for anemia,
Vaccines and treatments for infections,
Liquids and possible plasmapheresis to
prevent kidney damage, and
Blood thinners to prevent blood clots
+
Definitions:
!
See pages 24 – 31
for more information
on treatment.
Adjunctive treatment:
Medicine for symptoms
of myeloma
Bisphosphonates:
Drugs
that help improve bone
strength and prevent loss
of bone mass
Erythropoietin:
A drug
used to treat low red blood
cell counts
Plasmapheresis:
A process
that removes M-proteins
from the blood
1...,37,38,39,40,41,42,43,44,45,46 48,49,50,51,52,53,54,55,56,57,...84
Powered by FlippingBook