Treatment protocols for multiple myeloma

INTRODUCTION — The following material represents a subset of chemotherapy regimens that are used for the treatment of patients with multiple myeloma. This is not an exhaustive list; it includes regimens that are considered by the authors and editors to be commonly used and important for the care of patients with multiple myeloma. Additional regimens may be added over time, particularly as treatment for multiple myeloma evolves.

This topic review is intended to provide only a listing of chemotherapy regimens. It does not address the appropriate context for use of these regimens in the care of patients with multiple myeloma. Clinicians should refer to the individual disease-oriented topic reviews that discuss the use of these protocols in appropriate clinical situations:

●(See "Multiple myeloma: Overview of management".)

●(See "Multiple myeloma: Management in resource-limited settings".)

●(See "Multiple myeloma: Initial treatment".)

●(See "Multiple myeloma: Treatment of first or second relapse".)

These tables are provided as examples of how to administer these regimens; there may be other acceptable methods. All chemotherapy regimens must be administered by clinicians who are trained in the use of chemotherapy. The clinician is expected to use his or her independent medical judgment in the context of individual circumstances to make adjustments, as necessary.

REGIMENS

Bortezomib (Velcade) plus cyclophosphamide and dexamethasone (VCD or CyBorD) —  (table 1)

Bortezomib (Velcade) plus lenalidomide (Revlimid) and dexamethasone (VRd) —  (table 2)

Bortezomib (Velcade), thalidomide (Thalomid), and dexamethasone (VTd) —  (table 3)

Ixazomib, lenalidomide, and dexamethasone (IRd) —  (table 4)

Daratumumab, lenalidomide, and dexamethasone (DRd) —  (table 5)

Lenalidomide (Revlimid) plus dexamethasone (Rd) —  (table 6)

Melphalan, prednisone, and thalidomide (MPT) —  (table 7)

ACKNOWLEDGMENT — The UpToDate editorial staff acknowledges Scott M Wirth, PharmD, BCOP, who contributed to an earlier version of this topic review.