All information given here is of general nature only, a tumor therapy always belongs in the hands of an experienced oncologist!
How is the plasmocytoma treated?
The therapy of plasmocytoma does not follow fixed criteria. A therapy must always be individually tailored to the patient. It takes into account the patient’s age, state of health, psyche and wishes.
The stages of salmon and durie and the A- and B- classification are used as an objective evaluation standard for the therapy. In stage I there is generally no therapy for patients without symptoms (dormant plasmacytoma = smoldering plasmacytoma). A regular check of the laboratory values is carried out in order to enable early action to be taken in case of changes in the laboratory values.
In stage II and III, chemotherapy is generally given. This is carried out by the haematologist. In addition, alpha – interferon can be used as a treatment if necessary.
In addition, all complications that occur are treated immediately. If specific signs of disease or complications occur, various therapeutic options can be applied (unfortunately, we cannot always guarantee that the therapies mentioned are up to date):
- Chemotherapy (Alexanian – scheme)1. Monotherapy with melphalan and cortisone in the form of tablets; repetition approximately every two weeks 2. polychemotherapy (infusions; repetition every three to six weeks)
- High-dose chemotherapy with stem cell transplantation (only in exceptional cases in young patients)
- Radiotherapy
- Alpha-Interferon (see above) is considered a so-called messenger substance and acts as the body’s own active ingredient with a broad spectrum of action on the immune cells.
It inhibits the proliferation of plasma cells so that it can be used for stabilization (as a maintenance therapy) following chemotherapy. It is important to mention that alpha-interferon has too little effect as a single therapy.
Plasmocytoma/multiple myeloma is an incurable disease. Only patients who can undergo high-dose chemotherapy with stem cell transplantation have a low probability of cure.
Only a few patients are suitable for this therapy, which is also high-risk. However, if therapy is initiated in good time, the activity of the plasmocytoma can be reduced, so that in the ideal case, it is temporarily undetectable in the blood. This is called remission of the disease.
Unfortunately, this is not the same as a cure, since the disease can reappear after months or years (relapse). Particularly in cases of poor health, radical chemotherapy is avoided. In cases of imminent bone fractures due to pronounced bone resorption or severe bone pain, local radiation therapy (maximum dose of 45-50 Gray) can be performed.
This treatment is less stressful for the patient. It is usually combined with chemotherapy. What other accompanying therapeutic measures are available?
Extensive supporting measures are available for the treatment of myeloma:
- Freedom from pain is part of quality of life. Modern pain medication should make it possible to achieve painlessness. Bone pain can be very pronounced and thus affect the whole person. For pain therapy please see our new chapter.
- Anaemia can be reduced with the administration of erythropoietin, a growth factor for red blood cells.
- In order to reduce bone resorption, so-called bisphosphonates are used, whose effect is based on inhibition of osteoclasts (= bone-resorbing body cells). In this way fractures can be avoided if necessary.
- If so-called pathological fractures have already occurred, the fracture must be stabilized in interdisciplinary cooperation with the orthopedics department.
