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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Multiple Myeloma Be Treated?

Multiple Myeloma -- My husband diagnosed June 2015 - chemo from July to November and Dec stem cell transplant done. Remission to Feb 2017 - not quite 2-year hallmark to be eligible for another stem cell transplant. Originally presented in kidney and this time fluid around the heart and myeloma cells are present in this fluid. My husband has done 2 rounds of 5 days straight non-stop chemo. At this point, he wants to give up. I don t believe he should. Why would they not do another stem cell transplant (his cells for a second one are frozen and ready to be used) why? - even if he did not reach 2 years after his last transplant do it anyway. I will mention that they tested fluid around his heart and there are Myeloma cells in this fluid. It has been explained to me that the cancer morphed into another form so the ongoing Myeloma medication wouldn t recognize it and then the can continues to attach the body in the soft tissue. Help -- any suggestions or experience with this and what regiment puts this new problem of myeloma cells in the fluid dormant?
Fri, 24 Aug 2018
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General & Family Physician 's  Response
Hello,

Standard treatment options include:

1. Targeted therapy. Targeted drug treatment focuses on specific abnormalities within cancer cells that allow them to survive. Bortezomib (Velcade), carfilzomib (Kyprolis) and ixazomib (Ninlaro) are targeted drugs that block the action of a substance in myeloma cells that breaks down proteins. This action causes myeloma cells to die. Targeted-therapy drugs may be administered through a vein in your arm or in pill form. Other targeted-therapy treatments include monoclonal antibody drugs that bind to the specific proteins present on myeloma cells, causing them to die.

2. Biological therapy. Biological therapy drugs use your body's immune system to fight myeloma cells. The drugs thalidomide (Thalomid), lenalidomide (Revlimid) and pomalidomide (Pomalyst) enhance the immune system cells that identify and attack cancer cells. These medications are commonly taken in pill form.

3. Chemotherapy. Chemotherapy drugs kill fast-growing cells, including myeloma cells. Chemotherapy drugs can be given through a vein in your arm or taken in pill form. High doses of chemotherapy drugs are used before a bone marrow transplant.

4. Corticosteroids. Corticosteroids, such as prednisone and dexamethasone, regulate the immune system to control inflammation in the body. They are also active against myeloma cells. Corticosteroids can be taken in pill form or administered through a vein in your arm. Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, is a procedure to replace your diseased bone marrow with healthy bone marrow.

5. Before a bone marrow transplant, blood-forming stem cells are collected from your blood. You then receive high doses of chemotherapy to destroy your diseased bone marrow. Then your stem cells are infused into your body, where they travel to your bones and begin rebuilding your bone marrow.

6. Radiation therapy. This treatment uses beams of energy, such as X-rays and protons, to damage myeloma cells and stop their growth. Radiation therapy may be used to quickly shrink myeloma cells in a specific area — for instance, when a collection of abnormal plasma cells form a tumor (plasmacytoma) that's causing pain or destroying a bone.

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How Can Multiple Myeloma Be Treated?

Hello, Standard treatment options include: 1. Targeted therapy. Targeted drug treatment focuses on specific abnormalities within cancer cells that allow them to survive. Bortezomib (Velcade), carfilzomib (Kyprolis) and ixazomib (Ninlaro) are targeted drugs that block the action of a substance in myeloma cells that breaks down proteins. This action causes myeloma cells to die. Targeted-therapy drugs may be administered through a vein in your arm or in pill form. Other targeted-therapy treatments include monoclonal antibody drugs that bind to the specific proteins present on myeloma cells, causing them to die. 2. Biological therapy. Biological therapy drugs use your body s immune system to fight myeloma cells. The drugs thalidomide (Thalomid), lenalidomide (Revlimid) and pomalidomide (Pomalyst) enhance the immune system cells that identify and attack cancer cells. These medications are commonly taken in pill form. 3. Chemotherapy. Chemotherapy drugs kill fast-growing cells, including myeloma cells. Chemotherapy drugs can be given through a vein in your arm or taken in pill form. High doses of chemotherapy drugs are used before a bone marrow transplant. 4. Corticosteroids. Corticosteroids, such as prednisone and dexamethasone, regulate the immune system to control inflammation in the body. They are also active against myeloma cells. Corticosteroids can be taken in pill form or administered through a vein in your arm. Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, is a procedure to replace your diseased bone marrow with healthy bone marrow. 5. Before a bone marrow transplant, blood-forming stem cells are collected from your blood. You then receive high doses of chemotherapy to destroy your diseased bone marrow. Then your stem cells are infused into your body, where they travel to your bones and begin rebuilding your bone marrow. 6. Radiation therapy. This treatment uses beams of energy, such as X-rays and protons, to damage myeloma cells and stop their growth. Radiation therapy may be used to quickly shrink myeloma cells in a specific area — for instance, when a collection of abnormal plasma cells form a tumor (plasmacytoma) that s causing pain or destroying a bone. Hope I have answered your query. Let me know if I can assist you further.