NYU Langone doctors usually prescribe medications for multiple myeloma in three phases.
The initial phase of medical therapy, known as induction, generally lasts about four to six months. The goal is to reduce the number of cancerous plasma cells in the body.
In the consolidation phase, your doctor may prescribe high-dose chemotherapy for one month to help kill any remaining cancer cells after induction, and on recovery of the normal bone marrow, stem cells are harvested generally from the blood. The stem cells are stored in a frozen state until required.
Sometimes, stem cell transplantation is the next treatment used. In this procedure, a dose of chemotherapy meant to kill all the remaining malignant plasma cells is given, but this dose also permanently destroys the normal bone marrow cells. Then, the harvested stem cells collected earlier are reinfused into your body through a catheter to help restore bone marrow and the production of healthy blood cells.
If the multiple myeloma responds well to the high-dose chemotherapy given during consolidation, our doctors may delay stem cell transplantation unless the cancer returns or worsens. People who delay transplantation often still undergo stem cell collection so that stem cell transplantation can be performed in the future if needed.
Advances in the medications used to treat multiple myeloma mean that the cancer may respond well during induction. If so, NYU Langone doctors may prescribe lower doses of the induction-phase medications (or different medications) during the consolidation phase to further destroy cancer cells and to prevent the disease from worsening. Lower doses can help you to avoid the side effects of this treatment, which may include nausea, vomiting, low blood cell levels, and infection.
During the maintenance phase, which may occur after induction or consolidation, medications are prescribed to help keep the number of abnormal plasma cells in the body low and to prevent you from experiencing symptoms of multiple myeloma.
Maintenance may last for several years. Because it’s likely the disease may continue to grow or progress, your doctor can continue to see you periodically during maintenance to help you manage the condition, ensure you receive the supportive services you need, and determine if you are a candidate for a clinical trial.