Multiple Myeloma Treatment: Medicine, Chemotherapy, Bone marrow transplantation - Doctor

Multiple Myeloma - Treatments

How is multiple myeloma treated?

SGH is a comprehensive myeloma care centre. At SGH, you'll receive care from a team of doctors and nurses who work together to understand and offer you personalised care.

Treatment for myeloma depends on age, patient’s fitness or frailty at the time of diagnosis, presence, or absence of other medical issues like kidney failure, nerve damage symptoms etc.

Treatment of Myeloma:

All patients diagnosed with myeloma benefit from treatment as it can help relieve pain, control and minimise complications of the disease, stabilise your condition and slow the progress of multiple myeloma.

While myeloma is not a curable condition, there are many treatment options which are effective in controlling the disease for years.

The goal of treatment is to bring myeloma in to a good remission and to keep it there for as long as possible while preventing and minimising its complications and ultimately improve the quality of life.

Treatment of myeloma can be divided into different phases:

Induction Phase: with the aim to reduce the amount of cancer cells in the bone marrow
Consolidation Phase: with the aim of further deepen the response after induction therapy using treatments like an autologous haematopoietic stem cell transplant
Maintenance Phase

There are different treatment modalities used in treatment of myeloma. They are often used in combination and is tailored based on the patient’s disease characteristics and overall function.

Corticosteroids: Steroids can regulate the immune system and can control inflammation in the body. They are also very active against myeloma cells.
Chemotherapy: There are many chemotherapy drugs that are used to eradicate myeloma cancer cells and prevent their growth. There are different group of chemotherapy drugs used to treat myeloma: proteasome inhibitors, alkylators, immunomodulatory drugs etc.
Immunotherapy: Immunotherapy harnesses the power of your immune system to control myeloma. For example, monoclonal antibodies like daratumumab target a specific protein on the surface of cancerous plasma cells and make it easier for the immune cells to identify and kill them.
Haematopoietic Stem Cell Transplantation: Stem cell Transplantation involves the substitution of diseased bone marrow with healthy bone marrow stem cells. In most cases, the patient’s healthy stem cells are transplanted. Healthy blood-forming stem cells are collected from the patient by a process called apheresis and is stored in advance of the transplantation. During transplantation, high doses of chemotherapy drugs are then given to destroy the diseased bone marrow. This isfollowed by reinfusion of previously collected stem cells back into the blood which then home in on the bone marrow and start producing all blood and immune cells
Radiation therapy: Radiation therapy or radiotherapy uses high-energy radiation (rays or particles) to kill or damage cancer cells. It is usually used to shrink localised collection of cancerous plasma cells that form a tumor and is commonly used in combination with chemoimmunotherapy.

The management of multiple myeloma requires a multi-disciplinary team to support patients in various aspects of their care. We have a dedicated pharmacist-led education and medication reconciliation service, transplant and cell therapy co-ordinators and robust patient education supported by our advanced practice nurses. Our dedicated medical social workers also facilitate the provision of financial and psychosocial support to patients.

SGH also has many clinical trials that are specifically designed for and beneficial to myeloma patients. By collaborating with other institutions and industry partners in Singapore, South Asia and globally, we aim to continue bringing novel treatment options to Singapore myeloma patients via clinical trials.