If the plasma cell tumor isn’t in a bone, it could be removed with surgery.
Smoldering multiple myeloma
Smoldering myeloma patients may do well for a long time without treatment. For many patients, starting treatment early does not appear to help them live longer. These patients are watched carefully without beginning chemo or alternative treatments for myeloma.
Based on how abnormal the plasma cells appear under the microscope as well as the levels of immunoglobulins, some patients with smoldering multiple myeloma have a higher risk of progressing to active myeloma. In 1 study, treating those patients with lenalidomide (Revlimid) and dexamethasone until they developed symptoms or difficulties helped them live longer.
The drugs chosen are based on the individual’s health (for example their kidney function) and if a stem cell transplant is intended.
Many times, a combination comprising bortezomib, lenalidomide, and dexamethasone is used. Combinations containing bortezomib are particularly valuable in patients with kidney issues and people whose myeloma cells contain specific high-risk chromosome abnormalities.
Other combinations may be regarded as well.
For more on these medications and the more common combinations used, visit Drug Treatment for Multiple Myeloma.
Treatment for bone disorder (bisphosphonates) can be started together with chemo. If the regions of bone are still trigger symptoms, radiation therapy may be used.
A stem cell transplant might be a part of treatment. Alternatives for stem cell transplant have been discussed in Stem Cell Transplant for Multiple Myeloma.
Some patients have been given extra cycles of treatment . This is known as consolidation treatment and increases the odds of a complete response (where symptoms and signs of this disease go away).
Some patients (even some who did not have a stem cell transplant) may be given long-term treatment with lenalidomide or bortezomib. This is referred to as care treatment, andhelps delay the recurrence of the myeloma, but it can lead to serious side effects.
Many drug combinations can be useful in treating myeloma. If a medication combination stops functioning (or the myeloma comes back), others can be tried.