Multiple Myeloma

Multiple Myeloma

And Related Blood Diseases

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Duke’s myeloma specialists diagnose and treat myeloma, a form of blood cancer that usually starts in and spread throughout the bone marrow, and related blood diseases. Our experience using the latest therapies, and our ongoing myeloma research, ensures you receive the best possible care. 

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About Multiple Myeloma and Related Blood Diseases

When myeloma cells develop into a single collection of cells, typically in the bone, it is called a solitary plasmacytoma. Multiple myeloma refers to the presence of several myeloma tumors. MGUS (monoclonal gammopathy of uncertain significance) and smoldering myeloma cause no symptoms but refer to the development of abnormal cells that can eventually lead to multiple myeloma or related cancers. 

Rare, Related Diseases
We also treat rare diseases related to myeloma, including:

  • POEMS syndrome
  • Amyloidosis
  • Light or heavy chain deposition disease
  • Waldenstrom's macroglobulinemia, a form of lymphoma

Personalized Treatment Plan
We design a personalized treatment plan that is right for you. For example, if you are experiencing smoldering myeloma or MGUS, which typically do not produce symptoms, we may recommend active surveillance of your myeloma. Young, healthy people with symptoms may tolerate more intensive therapies, while older or frail people may benefit from gentler treatment options. 

We Work With Your Doctors
We routinely see people who travel to Duke for consultations and work with physicians near your home to ensure you receive the optimal care for your stage and type of myeloma. 

Our Locations
Duke Health offers locations throughout the Triangle. Find one near you.

Treatments

Active Surveillance

Often recommended if you have smoldering myeloma, or MGUS, which do not cause symptoms. We monitor you regularly and start treatment if symptoms appear or changes in your condition occur.

Blood and Bone Marrow Transplant

Multiple myeloma damages the cells in the bone marrow where healthy white blood cells, red blood cells and platelets are made. Blood and bone marrow transplant restores your healthy cell function by killing the multiple myeloma cells and replacing them with healthy cells. You may be eligible for a blood or bone marrow transplant using your own cells (autologous) or cells from a donor (allogeneic). Transplant is a very intensive and complex treatment. Determining if transplant is right for you is part of the expert care you will receive at Duke.

Chemotherapy

Kills or slows the growth of cancer cells. Systemic chemotherapy is administered administered orally or infusion through a vein. Some forms of chemotherapy must be given in the hospital or in a clinic, and others can be given at home.

Targeted Therapy

These newer drugs target precise targets in the cells, while sparing normal cells. Targeted therapy include proteasome inhibitors such as bortezomib (Velcade) and carfilzomib (Kyprolis), and “immunomodulatory agents” such as lenalidomide (Revlimid) and pomalidomide (Pomalyst). Targeted therapy may be used in combination with steroids or chemotherapy.

Radiation Therapy

High-energy beams target the tumor to kill or slow the growth of cancer cells. Radiation therapy is often used to treat specific painful spots of multiple myeloma in bones.

Bisphosphonate Therapy

May be prescribed to prevent broken bones related to myeloma.

Surgery

May be recommended to alleviate pain, stabilize broken bones or bones that are in danger.

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Tests

Blood Tests

Look for high calcium, anemia, elevated creatinine, and high protein levels, which may indicate the presence of myeloma or related conditions.

X-Rays, MRI, PET and CT scans

 These imaging tests can help diagnose the type and stage of your myeloma and provide information for your treatment plan.

Bone Marrow Biopsy

Removes a small amount of tissue for examination under a microscope. Biopsy is generally required to make a definitive diagnosis of cancer, including multiple myeloma.

Genetic Tests

These genetic tests examine the genetic makeup of your myeloma, which is different from other forms of genetic testing that look for conditions that may run in your family. Genetic studies help us better understand the biology behind your myeloma. This can help us predict how myeloma may act over time, and in some cases, choose the best possible therapies. Some genetic studies are only available at Duke.

Among the Best Cancer Hospitals in U.S.
Where you receive your cancer care is important. Duke University Hospital's cancer program is ranked among the nation's best by U.S. News & World Report for 2019–2020.

Why Choose Duke

Largest Multiple Myeloma Center in North Carolina
We treat 1,000 people with blood cancer each year, more than any other facility in North Carolina, and we have a team dedicated to working with people who have multiple myeloma. In addition, as a National Cancer Institute-designated Comprehensive Cancer Center, we offer a level of expertise that can only be found in the top four percent of cancer centers across the country with this designation.  We are also part of the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers dedicated to improving patient care.

A Team of Experts
Because myeloma can affect your blood, your bones, your kidneys, and other organs, you benefit from the close relationships our hematology/oncology specialists have with orthopaedic surgeons, kidney specialists, and other doctors throughout Duke who have extensive experience with myeloma. We discuss your care, collect opinions, and offer coordinated treatment recommendations and follow up.

Clinical Trial Access
We offer a wide range of clinical trials that may give you access to new drugs and new approaches not offered at other hospitals. For example, we offer clinical trials in bone marrow transplants and promising new drugs that are not yet available outside of a clinical trial. We also offer supportive care interventions such as exercise and stress management techniques, and senior adult assessments. Many of these approaches were pioneered at Duke and now offer new hope to people with myeloma. 

Support for You and Your Family
Our comprehensive support services are here for you throughout your treatment journey. We help minimize the side effects of treatment, and offer support to help you cope with the emotional and psychological effects of diagnosis and treatment. You may also utilize our services focusing on nutrition, guided imagery, anxiety control, and meditation. Our cancer survivorship clinic pulls together a range of resources specially designed to help you after your treatment ends. View all of our cancer support groups in our event calendar.