Multiple myeloma

Multiple myeloma falls into the general category of hematologic (blood) cancers, which primarily affect the blood, bone marrow (soft, spongy center of most bones) and lymph nodes, changing the production of blood cells and the way that they work. Myeloma affects the plasma cells found inside the bone marrow where blood is made. Myeloma cells develop when normal plasma cells transform and grow uncontrollably (see Figure below). As these abnormal cells multiply, they suppress the growth of healthy cells in the bone marrow. Because plasma cells are a part of the body’s immune system, this unusual cell growth can affect the body’s ability to fight infection and can result in anemia, bone damage and excessive bleeding from cuts.

Multiple myeloma is the second most common form of blood cancer in the United States. Thus, improved ways to treat this type of cancer is needed. Immunotherapies are a promising new strategy to treat multiple myeloma.

Treatment usually includes a combination of therapies, except for surgery, which is not typically part of routine treatment for this cancer. For many years, standard treatments for symptomatic myeloma have included chemotherapy, stem cell transplantation, and, in some cases, radiation therapy. Now immunotherapies are also an option. These therapies include a monoclonal antibody that is directed against CD38, a molecule that is present on myeloma cells, and other immunomodulatory agents, which stimulate the immune system. These immunotherapies can be used only for people who have received previous treatments or in combination with other drugs. They are not approved for all types and stages of multiple myeloma.

A new, promising aim of clinical research in multiple myeloma is the use of immune checkpoint inhibitors. These treatments work by targeting molecules that serve as checks and balances in the regulation of immune responses. By blocking inhibitory molecules or, alternatively, activating stimulatory molecules, these treatments are designed to unleash or enhance pre-existing anticancer immune responses. Other immunotherapies in clinical trials for multiple myeloma include vaccines, cytokines, adoptive cell transfer, monoclonal antibodies and oncolytic virus therapies.

As new cancer treatments are discovered for multiple cancer types, including multiple myeloma, they first become available in clinical trials for those who are eligible. Talk to your doctor to see whether a clinical trial is right for you and to discuss all of the treatment options available for your type and stage of multiple myeloma.


FDA-Approved Immunotherapies for Multiple Myeloma
As of 10/26/2016
daratumumab (Darzalex)
elotuzumab (Empliciti)
lenalidomide (Revlimid)
pomalidomide (Pomalyst)
thalidomide (Thalomid)

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