NCCN Guidelines for Patients® | Multiple Myeloma - page 51

49
NCCN Guidelines for Patients
®
Multiple Myeloma, Version 1.2014
4
Treatment guide
Active multiple myeloma
Many of the tests used for follow-up will be the same
as those described in Part 4.1 for diagnosis. A bone
marrow aspiration and biopsy may be done to check
if plasma cell levels in the bone marrow are falling.
A CBC will show if the number of blood cells is low
for each blood cell type. Tests of BUN, creatinine,
and calcium levels assess for symptoms of myeloma
such as kidney damage and bone damage. The other
blood tests and urine tests assess if M-protein levels
are falling. (See Part 2 on page 14 for more test
details.)
Test results and next treatment
The next treatment recommendations are based on
how the myeloma responded to primary treatment. To
read about the types of possible treatment responses,
see
Measuring treatment response
on page 45.
If you had a treatment response,
primary treatment
may be continued until no further treatment response
is seen with follow-up tests. Afterward, you will begin
observation and your doctor will monitor the cancer
with the follow-up tests listed in Chart 4.4.2. During
observation, tests to check the level of M-proteins in
your blood and urine should be done at least every 3
months. Along with follow-up tests you may also be
given maintenance treatment.
Maintenance treatment is medicine given in a lower
dose or less frequently to “maintain” good primary
treatment results. Maintenance treatment options are
listed in the lower part of Chart 4.4.2. Compared to
“other” regimens, “preferred” regimens work better,
have less serious side effects, or both.
If you didn’t have a response to primary
treatment,
then you will receive additional treatment,
possibly within a clinical trial. Additional treatment is
given when previous treatments failed to kill all of the
cancer or keep it away. See
Next steps
.
Next steps:
If tests showed that you did not have
a response to primary treatment, see
Chart 4.4.3 on page 50 for additional
treatment recommendations. Chart
4.4.3 also covers recommended
treatments for myeloma progression
or relapse after follow-up tests or
maintenance treatment.
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