High Dose Dexamethasone (HDD) therapy
This treatment may be used without supporting chemotherapy drugs in the initial treatment of myeloma. Younger people having this treatment are likely to be seriously ill with their myeloma and to have immunosuppression and/or renal failure. HDD may get the disease under control and enable chemotherapy followed by high dose chemotherapy and bone marrow transplant. This is one of the groups most likely to have needs at diagnosis.
- Bortezomib and dexamethasone
Disabling effects include:
- General side effects similar to thalidomide, except it may cause low platelets and bleeding disorders rather than thrombosis
- Steroid side effects
All of these regimens take between 3 and 6 months to complete. During the course of treatment, people are likely to be significantly fatigued and may have suffered significantly from chemotherapy side effects. 71% of people having had this treatment will then go on the have high dose chemotherapy and bone marrow or stem cell transplant at this stage.
Total treatment time and recovery for this group is likely to be 18 months to two years. Those that do not go on to have the high dose chemotherapy and bone marrow transplant are likely to be non-responders – this means their disease is difficult to control, they are likely to have continuing symptoms and problems and, if they do not respond to second line treatments may become terminally ill.
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Amended February 2009
