Information for the public

Further treatment for myeloma

Further treatment for myeloma

If your myeloma has relapsed, you may be offered bortezomib.

If you need treatment for myeloma symptoms after you have had at least 2 different courses of medicine, you may be offered a medicine called lenalidomide, together with dexamethasone.

NICE has written separate information on when bortezomib and lenalidomide can be used to treat relapsed myeloma. You can read the information on bortezomib here, and the information on lenalidomide here.

Stem cell transplants

You may be offered chemotherapy, followed by 1 of 2 different kinds of stem cell transplants: autologous or allogeneic.

When deciding if either kind of transplant is a good option for you, your care team will check your general health and fitness (a transplant is riskier for people who are not in good health).

Autologous stem cell transplants

Your care team should not decide whether an autologous transplant is a good option for you based only on your age or how well your kidneys are working.

If you have had an autologous stem cell transplant already, you may be offered a second one. This will depend on:

  • whether you're able to finish the chemotherapy given before the transplant, and how well this works

  • how much your first transplant helped, and for how long

  • how many other treatments you have had

  • your general health and fitness, and whether you have any other conditions as well as myeloma

  • how severe your myeloma is.

Allogeneic stem cell transplants

For allogeneic transplants, you and your care team should think about:

  • whether your condition can be treated with chemotherapy

  • how many myeloma treatments you have already had

  • whether someone can donate stem cells to you (a donor)

  • how the side effects of the transplant might be more difficult to deal with when you get older

  • the potential risks and benefits of the transplant, and how well you understand these

  • any other treatments that might help you instead.

Most people won't be offered an allogeneic stem cell transplant, as they are only a good option for a small number of people with myeloma. If an allogeneic transplant is an option for you, you may be offered it as part of a clinical trial. There is more information about clinical trials on NHS Choices.

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