Sunday, January 13, 2008

How to Treat Multiple Myelomas


Multiple myelomas are malignant tumors derived from the plasma cells in bone marrow. They include a range of diseases with unusual symptoms because plasma cells form antibodies. Myelomas can cause infections, pathologic fractures, spinal cord compression and renal failure. Treatments can relieve the symptoms, but no cure exists. The following steps will show how to treat multiple myelomas.


Difficulty: Challenging



Step One

Combine high-dose chemotherapy with a transplant of bone marrow or peripheral blood stem cell for patients requiring therapy. This approach has the highest response rates and best survival rates, but it is important to understand the limitations of therapy in the treatment of myelomas.

Step Two

Use radiation primarily as adjunctive therapy with chemotherapy because myelomas are sensitive to radiation. Radiation is used to treat lesions for pain and stabilize bones at risk for pathologic fractures.

Step Three

Treat spinal cord compression because of multiple myeloma with corticosteroid therapy. This therapy should be started immediately to reduce the swelling, and radiation therapy should be used to maintain or even reverse neurologic function.

Step Four

Perform autologous stem cell transplants as the most effective type of transplant. The patient's own stem cells are harvested and a normally lethal dose of radiation and chemotherapy is used to eradicate the remaining stem cells. The stem cells that were saved earlier are then reinfused into the patient.

Step Five

Provide allogenic transplants in rare cases. Stem cells from another donor (ideally an HLA-identical sibling) are used to reinfuse the patient. This method has the advantage of using healthy myeloma cells but risks an auto-immune response.

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