Chemotherapy agents for multiple myeloma
Fact-checked by Chemotherapy agents are a common class of medications used to treat many types of cancer, including multiple myeloma.
A type of blood cancer, myeloma arises when immune plasma cells in the bone marrow become abnormal and grow out of control, crowding out healthy blood cells and producing tissue-damaging proteins.
Chemotherapy medications are used at various stages to help slow myeloma growth. However, while they are very effective at killing cancerous cells, they can also harm healthy cells and cause significant side effects.
With the development of newer, more targeted therapies, chemotherapy does not play as central a role in myeloma treatment as it once did, but many patients will still receive it at some point.
What are chemotherapy agents?
Chemotherapy agents are a large group of medications that destroy cancerous cells. Cancer cells, including myeloma cells, grow and multiply more quickly than most healthy cells. For this reason, chemotherapy drugs are generally designed to target rapidly dividing cells.
Different chemotherapy agents work in different ways. Some directly damage the cells’ DNA, while others prevent them from dividing and making new cancer cells.
For some cancers, chemotherapy can help completely eliminate cancer cells and cure the disease. For others, like myeloma, a cure isn’t achievable, but chemotherapy can still help control cancer growth and ease symptoms. In myeloma, chemotherapy may be used to:
- reduce the number of cancer cells in the body for newly diagnosed patients who are not eligible for a stem cell transplant
- reduce the number of cancer cells in the body before a stem cell transplant
- destroy any remaining cancer cells and keep them from coming back after a stem cell transplant
- help slow cancer progression in people with relapsed or refractory myeloma, where the cancer has failed to respond to or returned after initial treatment
Chemotherapy agents for multiple myeloma
Chemotherapy agents commonly used for myeloma include:
- bendamustine (sold as Bendeka and others)
- cyclophosphamide (sold as Cytoxan and others)
- doxorubicin (sold as Doxil)
- melphalan (sold as Evomela and others)
Other chemotherapy agents, such as etoposide (sold as VePesid and others), are no longer commonly used for myeloma, but may be considered in certain situations.
Ultimately, the specific choice of medications depends on various factors, including the stage of treatment and a person’s general health status.
Chemotherapy is usually given in cycles, with medications administered on specific days, followed by a rest period to allow the body to recover. It may be administered by infusion into the bloodstream or taken orally, depending on the specific medication.
While it may sometimes be given alone, chemotherapy is usually combined with other myeloma treatments. In particular, these medications are commonly given with the corticosteroid dexamethasone, which helps kill myeloma cells and eases certain chemotherapy-related side effects.
Side effects
Chemotherapy affects all rapidly dividing cells, which include not only cancer cells but also certain healthy cells. That’s why these medications are usually associated with many different side effects.
The exact side effect profile will depend on the specific medications, but some possible side effects of chemotherapy include:
- constipation or diarrhea
- nausea, vomiting, and appetite loss
- easy bruising or bleeding
- hair loss
- increased risk of infection, including severe infections
- fatigue
- mouth sores
Most chemotherapy side effects go away after treatment is finished, but some medications can cause long-term organ damage. Chemotherapy can also affect fertility in both men and women.
Myeloma patients receiving chemotherapy are carefully monitored for these complications and treated with supportive care as necessary.
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