Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Multiple Myeloma
Question: My Father recently diagnosed with Multiple Myeloma. What is the first line of treatment or recommendation for MM patient. He have been complaining of persistent pain on his left knee x 1.5mos. No sign of swelling but in constant pain and unable to walk. Please help me if his knee pain related with recent diagnosis.
Brief Answer:
Revlimid with dexamethasone is the first line treatment.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your father has multiple myeloma. Bone pain is common in multiple myeloma.
Your father has knee pain and it is mostly due to multiple myeloma.
Treatment of multiple myeloma depends on stage of disease.
First line of treatment is revlimid.
Revlimid should be taken along with dexamethasone as a first line treatment in newly diagnosed case of multiple myeloma.
In chronic unresponsive patients bone marrow transplantation is helpful.
Bortezumab is also a useful medicine in certain cases.
Revlimid should be used with caution. It can causes many side effects like low blood count.
In kidney disease patients its dosages should be adjusted.
Normal dose is 25mg once a dose.
Since it is highly toxic and prescription based drugs so it should be used only on prescription of your treating doctor.
Hope I have answered your question. If you have any doubts then feel free to ask me. Thanks for using health care magic. Wish you a very good health.
Revlimid with dexamethasone is the first line treatment.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your father has multiple myeloma. Bone pain is common in multiple myeloma.
Your father has knee pain and it is mostly due to multiple myeloma.
Treatment of multiple myeloma depends on stage of disease.
First line of treatment is revlimid.
Revlimid should be taken along with dexamethasone as a first line treatment in newly diagnosed case of multiple myeloma.
In chronic unresponsive patients bone marrow transplantation is helpful.
Bortezumab is also a useful medicine in certain cases.
Revlimid should be used with caution. It can causes many side effects like low blood count.
In kidney disease patients its dosages should be adjusted.
Normal dose is 25mg once a dose.
Since it is highly toxic and prescription based drugs so it should be used only on prescription of your treating doctor.
Hope I have answered your question. If you have any doubts then feel free to ask me. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Hello Dr. Sanghvi,
Thank you so much for your response. I've been reading a lot trying to educate my self regarding this disease. The hematologist at St. Luke's Medical Center Philippines recommended Velcade 3.5mg weekly x 6mos along with Dexamethasone to help lower his creatinine level (4) and bone pain as well. He hasn't started the treatment. I'm a little apprehensive about it because of his age and other complications such as pneumonia. Is there anything we can do or give to alleviate the pain on his knee while at home waiting for initial MM treatment. The oral medication prescribed by his doctor doesn't seem to help. Is there any alternative topical wise? Please help! Thank u!
Thank you so much for your response. I've been reading a lot trying to educate my self regarding this disease. The hematologist at St. Luke's Medical Center Philippines recommended Velcade 3.5mg weekly x 6mos along with Dexamethasone to help lower his creatinine level (4) and bone pain as well. He hasn't started the treatment. I'm a little apprehensive about it because of his age and other complications such as pneumonia. Is there anything we can do or give to alleviate the pain on his knee while at home waiting for initial MM treatment. The oral medication prescribed by his doctor doesn't seem to help. Is there any alternative topical wise? Please help! Thank u!
Brief Answer:
You can take painkillers.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your doctor prescribed him velcade. It contain bortezomib. As I said earlier bortezomib can be used in some cases of multiple myeloma.
For pain relief he can take painkillers like tramadol according to doctor's advice. He should avoid routine pain killers like diclofenac because his creatinine level is high.
Tramadol is a prescription based medicine so consult your doctor and take treatment accordingly.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
You can take painkillers.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your doctor prescribed him velcade. It contain bortezomib. As I said earlier bortezomib can be used in some cases of multiple myeloma.
For pain relief he can take painkillers like tramadol according to doctor's advice. He should avoid routine pain killers like diclofenac because his creatinine level is high.
Tramadol is a prescription based medicine so consult your doctor and take treatment accordingly.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Dr. Sanghvi,
I just asked my brother in Philippines about my father's pain on his knee. I just talked to my father this morning and he said the pain is coming from behind the knee not on the knee cap. He also mentioned numbness/tingling sensation and he is having difficulty bending his knee. What could that be? Please help!
I'm Vie by the way.
I just asked my brother in Philippines about my father's pain on his knee. I just talked to my father this morning and he said the pain is coming from behind the knee not on the knee cap. He also mentioned numbness/tingling sensation and he is having difficulty bending his knee. What could that be? Please help!
I'm Vie by the way.
Brief Answer:
He should go for MRI knee.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern. Your father has knee pain with tingling and numbness. Mostly it could be due to multiple myeloma or it may be due to some other pathology also. He should go for MRI of knee.
It gives exact idea regarding pathology, Whether it is due to multiple myeloma only or some other cause.
Then he should take treatment accordingly.
Till that he can take painkillers as I said earlier for symptomatic pain relief.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
He should go for MRI knee.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern. Your father has knee pain with tingling and numbness. Mostly it could be due to multiple myeloma or it may be due to some other pathology also. He should go for MRI of knee.
It gives exact idea regarding pathology, Whether it is due to multiple myeloma only or some other cause.
Then he should take treatment accordingly.
Till that he can take painkillers as I said earlier for symptomatic pain relief.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Yogesh D
Dr. Sanghvi, will CT scan work? The hospital near by doesn't have MRI capability. Also, he is currently on Tramadol for his knee pain and I also told them to apply topical cream for joint pain/arthritis which somewhat help. He will have his initial Velcade treatment Tuesday. Sorry that I'm just going on and on about this, it's just hard because I'm not there. I appreciate all your help.
Brief Answer:
If bony injuries are there then ct will work.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Dear feel free to ask anything at any time. No need to worry. I can understand your condition.
If your lesion is due to multiple myeloma then ct scan will work. If if you have any other soft tissue lesion then ct will not work. So overall MRI is better option. But if you don't have hospital with MRI facilities then its ok to go with ct scan.
Start your bortezomib according to your doctor's advice. Take painkillers till you get definite cause.
Feel free to ask me any questions. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
If bony injuries are there then ct will work.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Dear feel free to ask anything at any time. No need to worry. I can understand your condition.
If your lesion is due to multiple myeloma then ct scan will work. If if you have any other soft tissue lesion then ct will not work. So overall MRI is better option. But if you don't have hospital with MRI facilities then its ok to go with ct scan.
Start your bortezomib according to your doctor's advice. Take painkillers till you get definite cause.
Feel free to ask me any questions. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Raju A.T
Dr. Sanghvi do you mind explaining this for me? I contact the doctor as of now but I'm able to see the lab results but I just don't know the interpretation about the whole thing. Please help so I can understand. Thank you!
BETA 2 Microglobulin……..23,069.
Ionized Calcium…..1.27
Creatinine……4.61
Blood Urea Nitrogen….46
Sodium….135
Potassium…4.0
Chloride…104
Bicarbonate…22
BETA 2 Microglobulin……..23,069.
Ionized Calcium…..1.27
Creatinine……4.61
Blood Urea Nitrogen….46
Sodium….135
Potassium…4.0
Chloride…104
Bicarbonate…22
Brief Answer:
Please write down the unit in beta 2 microglobulin value.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your sodium, potassium, chloride and calcium level are normal.
Your urea and creatinine is increased. It is suggestive of bad prognosis.
Please write down the unit in beta 2 microglobulin value.
It is prognostic indicator in multiple myeloma.
If it is less than 3.5 mg/dl then it is suggestive of good prognosis.
If it is more than 5.5mg/dl then it indicate bad prognosis.
You can correlate that in your report with units.
Feel free to ask further questions.
I will be happy to answer.
Thanks for using health care magic.
Wish you a very good health.
Please write down the unit in beta 2 microglobulin value.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your sodium, potassium, chloride and calcium level are normal.
Your urea and creatinine is increased. It is suggestive of bad prognosis.
Please write down the unit in beta 2 microglobulin value.
It is prognostic indicator in multiple myeloma.
If it is less than 3.5 mg/dl then it is suggestive of good prognosis.
If it is more than 5.5mg/dl then it indicate bad prognosis.
You can correlate that in your report with units.
Feel free to ask further questions.
I will be happy to answer.
Thanks for using health care magic.
Wish you a very good health.
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
