Maintenance therapy for multiple myeloma

Maintenance therapy is usually given after a stem cell transplant. Maintenance therapy may also be used after induction therapy in people who don’t have a stem cell transplant. A maintenance therapy drug is usually given in a low dose over a long period of time. This helps to keep the person in remission and prevent relapse. Because the drug is given at a low dose, there tend to be fewer side effects and the person is able to have a better quality of life.

Targeted therapy

Targeted therapy is the main type of maintenance therapy for multiple myeloma. Targeted therapy drugs used as maintenance therapy include:

  • lenalidomide (Revlimid)
  • bortezomib (Velcade)
  • thalidomide (Thalomid)

Corticosteroids

Corticosteroids are steroid hormones that act as an anti-inflammatory by reducing swelling and lowering the body’s immune response (the immune system’s reaction to foreign substances). Sometimes corticosteroids are used along with or instead of targeted therapy as maintenance therapy for multiple myeloma. The most common corticosteroids used include:

  • dexamethasone (Decadron, Dexasone)
  • prednisone

Expert review and references

  • Alberta Health Services. Multiple Myeloma Clinical Practice Guideline LYHE-003. Alberta Health Services; 2015.
  • Dispenzieri A, Lacy MQ, Kumar S . Multiple myeloma. Greer JP, Arber DA, Glader B, List AF, Means RT Jr, Paraskevas F, Rodgers GM, Foerster J, (eds.). Wintrobe's Clinical Hematology. 13th ed. Lippincott Williams & Wilkins; 2014: 98: 2046-2097.
  • Mushi NC, Anderson KC . Plasma cell neoplasms. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 112: 1682-1719.
  • Myeloma Canada. Multiple Myeloma Patient Handbook. Third ed. Kirkland, QC: Myeloma Canada; 2014.
  • National Comprehensive Cancer Network. Multiple Myeloma (Version 4.2015). National Comprehensive Cancer Network; http://www.nccn.org/professionals/physician_gls/pdf/myeloma.pdf.
  • Rajkumar SV, Kyle RA . Diagnosis and treatment of multiple myeloma. Wiernik PH, Goldman JM, Dutcher JP, Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 33: 637-664.
  • Shah D. Multiple Myeloma Treatment & Management. 2015: http://emedicine.medscape.com/article/204369-treatment.
  • The Leukemia & Lymphoma Society. Myeloma. Revised ed. White Plains, NY: The Leukemia & Lymphoma Society; 2013: http://www.llscanada.org/content/nationalcontent/resourcecenter/freeeducationmaterials/myeloma/pdf/myeloma.pdf.

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