Treatment of relapsed or refractory myeloma

Of those people who responded well to first line treatment, almost all will have a relapse or recurrence eventually. For young people who have had high dose chemotherapy this may be many years later, for older people it is often within a few months or a year of initial treatment. Once myeloma has recurred it may be possible to gain another shorter remission with further treatment. This may involve any of the chemotherapy drugs and other treatments described under first line therapy. It is likely to involve-:

• a course of chemotherapy
• Spot radiotherapy treatments for areas of bone pain.

A combination of supportive treatments designed to improve or maintain quality of life-:

• reducing pain
• controlling symptoms of anaemia

Amended February 2009