How to treat myeloma

How to treat myeloma? When myeloma occurs in a patient, how to treat it becomes his main focus. Firstly, it is very difficult to treat the tumor, and secondly, the cure rate of the tumor is very low, which brings a great burden to the patient's body and mind. If you don't know how to treat it, you are likely to be deceived. So you need to understand how to treat myeloma. Let's take a look below.

1. Treatment principles

(1) Generally speaking, asymptomatic MM patients do not require treatment; treatment is only started for symptomatic myeloma.

(2) 80% of high-risk asymptomatic MM patients can be transformed into MM within 2 years and can be treated and intervened early.

2. General treatment

(1) If the hemoglobin level is lower than 60 g/L, red blood cell transfusion or subcutaneous injection of erythropoietin should be performed if necessary.

(2) Hypercalcemia: hydration with isotonic saline, prednisone, calcitonin, bisphosphonates, and treatment of the underlying disease.

(3) Hyperuricemia: Hydration of hyperuricemia and oral administration of allopurinol.

(4) Treatment of the primary disease of hyperviscosity and temporary plasma exchange if necessary.

(5) Treatment of the primary disease of renal failure and hemodialysis if necessary.

(6) Infections are treated with antibiotics. Regular prophylactic immunoglobulin injections are effective for patients with recurrent infections.

3. Chemotherapy

Commonly used drugs include:

① Currently, targeted drugs mainly include proteasome inhibitors (bortezomib, carfilzomib) and immunomodulators (thalidomide, lenalidomide or pomalidomide);

② Traditional chemotherapy drugs include melphalan, doxorubicin and cyclophosphamide;

③Glucocorticoids such as dexamethasone, prednisone, etc.

Commonly used chemotherapy combinations are: proteasome inhibitors/immunomodulators + glucocorticoids; or proteasome inhibitors/immunomodulators + traditional chemotherapy drugs + glucocorticoids; or traditional chemotherapy drugs + glucocorticoids (belonging to traditional chemotherapy regimens).

It has been proven that the efficacy of regimens containing new proteasome inhibitors/immunomodulators is significantly better than traditional chemotherapy regimens. Therefore, MM patients should try to use regimens containing new proteasome inhibitors/immunomodulators.

(1) Patients who are suitable for autologous transplantation should use a combination regimen that does not contain melphalan to avoid damage to hematopoietic stem cells;

(2) For patients who are not suitable for autologous transplantation, such as those over 65 years old, a combination regimen containing melphalan can be used with traditional drugs.

4. Hematopoietic stem cell transplantation

Autologous hematopoietic stem cell transplantation is recommended for all eligible patients, and allogeneic hematopoietic stem cell transplantation may be considered for some young high-risk patients as appropriate.

5. Radiotherapy

Used for patients with localized myeloma, local bone pain and symptoms of spinal cord compression.

The above content introduces in detail how to treat myeloma. I hope it can help everyone. In the process of fighting the disease, in addition to active treatment, patient care is also very important. Therefore, family members should pay more attention to this and consult doctors on how to carry out correct and effective care.