Refractory and Relapsed
Some patients still have myeloma cells in their bone marrow after treatment. This is called refractory myeloma. If you have refractory myeloma, your treatment options include using drugs not used during your past treatment to induce remission or an autologous stem cell transplantation to try to produce a longer remission
If your myeloma returns after a remission, you've relapsed. You'll need more chemotherapy with the same or different drugs used earlier during treatment or an autologous stem cell transplantation if you're a candidate for one.
Treatments with novel agents for relapsed/refractory myeloma include
- Carfilzomib (KyprolisTM)
- Panobinostat (Farydak®)
- Pomalidomide (Pomalyst®)
- Bortezomib (Velcade®)
- Velcade as a single agent or in combination with dexamethasone
- Lenalidomide (Revlimid®)
A number of different chemotherapy agents may be used in combination with
dexamethasone for relapsed/refractory myeloma. Some possibilities include
- Cyclophosphamide (Cytoxan®), vincristine (Oncovin®) and doxorubicin
- High-dose cyclophosphamide
- Cisplatin (Platinol®), doxorubicin hydrochloride, cyclophosphamide, etoposide
(Toposar®, VePesid®), plus thalidomide (Thalomid®)
- Cyclophosphamide, etoposide, cisplatin.
If you would like to read about these drugs individually, including information about side effects, click here.