What is included in adjunctive therapy for multiple myeloma (MM)?

Updated: May 11, 2021
  • Author: Dhaval Shah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Adjunctive therapy for MM includes radiation therapy to target areas of pain, impending pathologic fracture, or existing pathologic fracture. Bisphosphonate therapy serves as prophylaxis (ie, primary, secondary) against skeletal events (eg, hypercalcemia, spinal cord compression, pathologic fracture, need for surgery, need for radiation). Evidence suggests that it may be effective in treating bone pain and in decreasing the likelihood of lesion recurrence. [45, 46, 47]

Adjunctive therapy may also include any of the following, as appropriate:

  • Erythropoietin
  • Corticosteroids
  • Surgical intervention
  • Plasmapheresis

Studies of chimeric antigen receptor (CAR) T cell therapy using B-cell maturation antigen (BCMA) have reported objective in responses in patients with relapsed and/or refractory MM; in most patients, however, disease remission does not last longer than 18 months. Attempts to improve results are in progress. [48, 49]


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