50 NCCN Guidelines for Patients ® : Multiple Myeloma, 2018 4 Treatment guide Active (symptomatic) multiple myeloma Talk to your doctor about which treatment options are available to you. He or she can explain the combination of drugs and side effects that may occur. Some of the drugs listed here require that you had at least 1 to 3 prior treatments. Certain drugs in this list are stronger than others and may not be helpful for people who are frail or elderly. Some may also put you at risk for serious side effects. Your doctor will consider these things along with the extent of disease before deciding on your next treatment. It’s important to discuss all of these factors, and your treatment goals, with your doctor to choose the best option for you. Follow-up tests Follow-up tests will continue during treatment. The treatment response will be assessed after every cycle. If the cancer continues to progress despite trying additional treatment, sometimes palliative care is recommended. Palliative care (also called supportive care) is given to relieve symptoms of cancer and side effects of cancer treatment. It doesn’t aim to treat the cancer, but rather aims to improve your quality of life. Next steps If you had an allogeneic stem cell transplant, see Guide 7 on page 51 for the next options. If you had an autologous stem cell transplant, see Guide 8 on page 52 for the next options.