Multiple Myeloma Treatment

Multiple myeloma occurs when plasma cells become cancerous and often form tumors in the bones. One tumor of cancerous plasma cells is called a plasmacytoma, and if a person has multiple tumors, it is called multiple myeloma.1

Treatment for multiple myeloma is based on several factors, including the stage of the disease, whether certain antibodies are present, whether certain genetic mutations are present, whether the kidneys are damaged, how the cancer responds to initial treatment, and the age and general health of the individual.2

Types of treatment for multiple myeloma

There are several different types of treatment that may be used for multiple myeloma, including:

  • Chemotherapy
  • Targeted therapy
  • Immunotherapy
  • Radiation therapy
  • Watchful waiting
  • Surgery
  • Stem cell transplant2


Chemotherapy is the use of drugs to stop cancer cells. Chemotherapy medications may be used in combination, and they may be taken by mouth or injected into a vein or muscle. Chemotherapy works by targeting fast-growing cells, such as cancer cells. However, there are other fast-growing cells in the body that can also be affected, such as those in the gastrointestinal tract and hair.2

Targeted therapy

Targeted therapies are cancer treatments that block or slow the spread of cancer by interfering with specific areas of cancer cells that are involved in the growth of cancer cells, or by focusing on particular characteristics that are unique to cancer cells. While chemotherapy drugs are typically cytotoxic, meaning they kill cancer cells, targeted therapy is typically cytostatic, meaning it blocks the growth of cancer cells. The types of targeted therapy that may be used to treat multiple myeloma include monoclonal antibodies, proteasome inhibitors, histone deacetylase (HDAC) inhibitors, and nuclear export inhibitors.2

  • Monoclonal antibodies are created in the laboratory to identify and block cancer growth or kill cancer cells, or may be used to deliver chemotherapy medications to cancer cells.2
  • Proteasome inhibitors block the action of proteasomes, which remove proteins inside cancer cells. By blocking the normal action of proteasomes, these treatments can help cause the proteins to increase in the cancer cell and can lead to the cancer cell’s death.2
  • HDAC inhibitors block enzymes that are important for cell division and may block the growth of cancer cells.
  • Nuclear export inhibitors work by impacting the XPO1 protein to disrupt normal distribution within cancer cells of other important proteins, which can result in cancer cell death.2,3


Immunotherapy, or biologic therapy, is a type of treatment that boosts the body’s immune system to fight the cancer. Immunotherapies work in various ways, not all of which are completely understood.2,3

Radiation therapy

Radiation therapy uses high-energy radiation. Radiation may be used to treat plasmacytoma or tumors in multiple myeloma that have not responded to chemotherapy.2,4

Watchful waiting

In certain circumstances, watchful waiting may be recommended if a person with multiple myeloma is not experiencing symptoms from their disease. During watchful waiting, the person does not receive treatment for blood cancer, although problems like infections are treated. A person’s health is monitored closely during watchful waiting, and doctors will watch for any changes in their condition and the potential appearance of symptoms.2

Stem cell transplants

Stem cell transplants are another potential treatment option for people with multiple myeloma. Stem cell transplants are used in combination with high doses of chemotherapy. The high dose of chemotherapy destroys the cancer cells and also damages healthy blood cells. The transplant of stem cells, immature cells that can become new blood cells, is given to restore the bone marrow. The stem cells may be gathered from the patient prior to chemotherapy (called an autologous transplant), or they may be given by a donor (called an allogeneic transplant). Not everyone is a candidate for stem cell transplants, however, as the high doses of chemotherapy can be very taxing on a person’s body and may not be tolerated by older patients or those with other health problems.2

Clinical trials

Clinical trials are a type of research where new treatments are studied. Clinical trials are an important part of the scientific process to find and prove the safety and effectiveness of new treatments, and they offer patients a chance to receive the latest treatments and be closely monitored by healthcare professionals. Clinical trials can be found by talking to a doctor or through the website Patients can discuss treatment options with their doctor to determine if they might be eligible to participate in a clinical trial.2,5

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Written by: Emily Downward | Last reviewed: October 2020