NCCN Guidelines for Patients® | Multiple Myeloma - page 49

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NCCN Guidelines for Patients™: Multiple Myeloma
Version 1.2012
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5.4 Active multiple myeloma
Part 5.4.3 describes treatment for progression or relapse of myeloma. This treatment
is called salvage therapy. Compared to “other” regimens, “preferred” regimens work
better, have less serious side effects, or both. There is a wide range of treatment options.
Primary treatment can be repeated if it was completed more than 6 months ago. Other
options include chemotherapy alone, targeted therapy alone, or combination regimens
that may also include steroids. If the cancer progresses after salvage therapy, supportive
care is recommended.
5.4.3 Treatment for relapse or progression
Preferred salvage therapy
Repeat primary treatment if it ended >6 mo ago,
Bortezomib,
Bortezomib/dexamethasone,
Bortezomib/lenalidomide/dexamethasone,
Bortezomib/liposomal doxorubicin,
Bortezomib/thalidomide/dexamethasone,
Carfilzomib
Cyclophosphamide/bortezomib/dexamethasone,
Cyclophosphamide/lenalidomide/dexamethasone,
Dexamethasone/cyclophosphamide/etoposide/cisplatin,
Dexamethasone/thalidomide/cisplatin/doxorubicin/
cyclophosphamide/etoposide ± bortezomib,
High-dose cyclophosphamide,
Lenalidomide/dexamethasone, or
Thalidomide/dexamethasone
Other salvage therapy
Bendamustine,
Bortezomib/vorinostat, or
Lenalidomide/bendamustine/dexamethasone
Best supportive care
Best supportive care
Definitions:
!
See pages 24 – 25
for more information
on salvage therapy.
Anemia:
A health condition
in which the number of red
blood cells is low
M-protein:
An abnormal
antibody made by myeloma
cells that doesn’t fight germs
Maintenance treatment:
Medicine given to continue
good primary treatment
results
Plasma cell:
A white blood
cell that makes germ-
fighting proteins
Supportive care:
Treatment
of the symptoms of a
disease
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