Multiple Myeloma

Corticosteroids (Steroids)

Corticosteroids (steroids), which include and , are an important part of the treatment of multiple myeloma. Corticosteroids can be used alone or in a combination with other drugs as part of the treatment process. In addition, corticosteroids can be used to help decrease nausea and vomiting that may be caused by chemotherapy.

The common side effects of using corticosteroids include high blood sugar, increased appetite and weight gain, problems sleeping, and changes in mood, such as becoming irritable or hyper.

When used for a long time, corticosteroids can also suppress the immune system, which increases the risk for serious infections. Corticosteroids can also weaken bones.

Over time, most of these side effects will go away once the drug use is stopped.

Immunomodulating Agents

There are three immunomodulating agents that are used to treat multiple myeloma. The first agent to be developed, , caused severe birth defects when taken during pregnancy. The remaining agents are related to and so may also cause birth defects. Immunomodulating agents can increase the risk of serious blood clotting and so are often prescribed with aspirin or another blood thinner.

(Revlimid) is an immunomodulating agent used to treat multiple myeloma. The most common side effects of this drug are thrombocytopenia, or low platelets, and having low white blood cell counts. can cause painful nerve damage and does increase the risk of blood clots.

may be given to patients with myeloma in remission after undergoing a stem cell transplant or after initial treatment. The helps to prolong the remission.

Proteasome Inhibitors

Proteasome inhibitors stop enzyme complexes (proteasomes) in cells from breaking down the proteins needed to control cell division. They affect tumor cells more than normal cells but still cause side effects.

() was the first proteasome inhibitor to be approved and is often used to treat multiple myeloma, especially in those patients with kidney problems. is injected directly into a vein or under the skin once or twice a week.

The most common side effects are nausea, vomiting, fatigue, diarrhea, constipation, fever, decreased appetite, and lowered blood counts. The platelet count and white blood cell count are affected the most by .

can cause nerve damage, which can lead to numbness, tingling, or pain in the hands/feet. However, if given under the skin, the risk of nerve damage is lessened.

Some patients may develop shingles while on . You may be prescribed an anti-viral medicine, such as acyclovir, to help prevent this.

may be given to patients with myeloma in remission after undergoing a stem cell transplant or after initial treatment. The  helps to prolong the remission.

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