Treatment Options for Plasma Cell Neoplasms

Monoclonal Gammopathy of Undetermined Significance
Isolated Plasmacytoma of Bone
Extramedullary Plasmacytoma
Multiple Myeloma
Refractory Multiple Myeloma

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment of monoclonal gammopathy of undetermined significance (MGUS) is usually watchful waiting. Regular blood tests to check the level of M protein in the blood and physical exams to check for signs or symptoms of cancer will be done.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with monoclonal gammopathy of undetermined significance. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Treatment of isolated plasmacytoma of bone is usually radiation therapy to the bone lesion.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with isolated plasmacytoma of bone. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Treatment of extramedullary plasmacytoma may include the following:

• Radiation therapy to the tumor and nearby lymph nodes.
• Surgery, usually followed by radiation therapy.
• Watchful waiting after initial treatment, followed by radiation therapy, surgery, or chemotherapy if the tumor grows or causes symptoms.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with extramedullary plasmacytoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Patients without symptoms may not need treatment. When symptoms appear, the treatment of multiple myeloma may be done in phases:

Induction therapy : This is the first phase of treatment. Its goal is to reduce the amount of disease, and may include one or more of the following:

• Corticosteroid therapy.
• Thalidomide or lenalidomide therapy.
• Targeted therapy with a proteasome inhibitor (bortezomib).
• Chemotherapy.
• A clinical trial of different combinations of treatment.

Consolidation chemotherapy : This is the second phase of treatment. Treatment in the consolidation phase is to kill any remaining cancer cells. High-dose chemotherapy is followed by either:

• one or two autologous stem cell transplants, in which the patient's stem cells from the blood or bone marrow are used; or
• one allogeneic stem cell transplant, in which the patient receives stem cells from the blood or bone marrow of a donor.

Maintenance therapy : After the initial treatment, maintenance therapy is often given to help keep the disease in remission for a longer time. Several types of treatment are being studied for this use, including the following:

• Chemotherapy.
• Biologic therapy with interferon.
• Corticosteroid therapy.
• Thalidomide or lenalidomide therapy.
• Targeted therapy with a proteasome inhibitor (bortezomib).

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with multiple myeloma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Treatment of refractory multiple myeloma may include the following:

• Watchful waiting for patients whose disease is stable.
• A different treatment than treatment already given, for patients whose tumor kept growing during treatment. (See Multiple Myeloma treatment options.)

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with refractory multiple myeloma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.