Chemotherapy for active myeloma

Chemotherapy is the use of anti-cancer (cytotoxic) drugs. Chemotherapy drugs stop cancer cells dividing and reproducing. The drugs circulate in the blood and can reach myeloma cells all over the body.

Treatment often involves a combination of two or more chemotherapy drugs. These may be given with other drugs, such as steroids and targeted therapies. You will have treatment for a few days, followed by a rest period of a few weeks. The treatment and the rest period make up a cycle of treatment. Usually between 4–6 cycles will make up a complete course of treatment.

You will usually have chemotherapy as an outpatient, but sometimes you may need to spend a few days in hospital.

During the course of treatment, you will have regular blood tests to check the effect of the drugs. The dose of the drugs may be changed according to the results of your blood tests or any side effects.

Chemotherapy drugs used to treat myeloma include:

Some chemotherapy drugs for myeloma are given by injection into a vein (intravenously). Others are taken as tablets or capsules (orally). When these drugs are given as tablets, they can have fewer side effects. This makes them more suitable for people who aren’t able to have intensive treatments.

Having combined treatments

Chemotherapy is often combined with targeted therapies and steroids. Drug combinations that are used include:

The length of treatment will depend on which treatments are used and how well the myeloma responds to the drugs. A course of treatment usually takes several months to complete.

Lines and ports

If you’re having your treatment by drip (infusion), your doctor may suggest you have a plastic tube inserted into a vein in your chest (central line) or the crook of your arm (PICC line). Sometimes an implantable port is used. This is a thin, soft plastic tube that’s put into a vein in the chest and has an opening (port) just under the skin of the chest or arm.

Lines and ports can stay in place during the course of your treatment. This can be used to take blood samples and give you treatment. Your nurses will show you how to care for the line or port when you’re at home.

Back to Chemotherapy explained

When is chemotherapy used?

Chemotherapy is used to kill cancer cells in the body. Your doctor will explain if chemotherapy is advised for you.

How do chemotherapy drugs work?

Chemotherapy drugs work by stopping cancer cells reproducing. The drugs can also affect healthy cells, causing side effects.