by EBSCO Medical Review Board

Peripheral Stem Cell Transplant

Multiple myeloma (MM) lowers the number of healthy blood cells in the bone marrow. A peripheral stem cell transplant (PSCT) is a way to help the bone marrow return to normal.

Stem cells (immature, unformed cells) are taken from your own blood or bone marrow, then frozen. (Donor blood is given to you by someone else.) High dose chemotherapy is given to kill any leftover cancer in the body before the PSCT. Then, the stem cells are returned to the body. They travel to bone marrow sites and slowly repopulate all types of blood cells the body needs. After PSCT, the new cells should be cancer free and can make new, healthy cells.

Most people use their own stem cells to treat MM.

Targeted Therapy

These medicines affect certain proteins that cancer cells need to grow and spread. The drugs used are:

  • Bortezomib
  • Carfilzomib
  • Ixazomib
  • Panobinostat

These drugs are used with chemotherapy, and for MM that returns or is hard to treat.

Some problems are:

  • Fluid buildup in the body
  • Diarrhea
  • Nausea
  • Lightheadedness
  • Cough
  • Feeling tired
  • Anemia—panobinostat
  • Higher risk of infection—panobinostat

Biologic Therapy

These medicines change how the immune system works so it can find the cancer cells to destroy them. The drugs used are:

  • Elotuzumab
  • Daratumumab

These drugs are used with chemotherapy, and for MM that returns or is hard to treat.

Some problems are:

  • Fluid buildup in the body
  • Constipation
  • Nausea
  • Back pain
  • Lightheadedness
  • Cough
  • Feeling tired
  • Weak muscles or nerve problems—daratumumab

References

Chemotherapy and drug therapy. Leukemia & Lymphoma Society website. Available at: https://www.lls.org/disease-information/myeloma/treatment. Accessed May 3, 2019.

Drug therapy for multiple myeloma. American Cancer Society website. Available at: https://www.cancer.org/cancer/multiple-myeloma/treating/chemotherapy.html. Updated January 3, 2019. Accessed May 3, 2019.

Michels TC, Petersen KE. Multiple myeloma: Diagnosis and treatment. Am Fam Physician. 2017;95(6):373-383A.

Multiple myeloma. EBSCO DynaMed website. Available at:  http://www.dynamed.com/topics/dmp~AN~T116888/Multiple-myeloma . Updated March 29, 2019. Accessed May 3, 2019.

Multiple myeloma. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/hematology-and-oncology/plasma-cell-disorders/multiple-myeloma. Updated May 2018. Accessed May 3, 2019.

Stem cell transplant for multiple myeloma. American Cancer Society website. Available at: https://www.cancer.org/cancer/multiple-myeloma/treating/chemotherapy.html. Updated February 28, 2018. Accessed May 3, 2019.

Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/myeloma/patient/myeloma-treatment-pdq#%5F46. Updated April 9, 2019. Accessed May 3, 2019.

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