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Frequently Asked Questions

FREQUENTLY ASKED QUESTIONS
What information is available from the IMF other than what I can find on the website?
The IMF is able to provide assistance via computer in many ways.The Hotline answered this question in the Summer 2010 issue of Myeloma Today.
Should treatment be abandoned for frail elderly patients who cannot tolerate the side effects? Or is there a way to make the treatment more tolerable?
Elderly and/or frail myeloma patients who have been plagued with side effects do not have to abandon all hope of tolerating treatment; often, simply reducing the treatment dose is an appropriate strategy to allow them to continue therapy.

Is there a consensus among myeloma doctors on VELCADE® dosing?
Bortezomib (VELCADE) is an effective and widely used treatment for multiple myeloma. Because of bortezomib’s effectiveness, it is essential to ensure that patients are able to tolerate it well and not discontinue receiving bortezomib infusions because of side effects.
Is the use of gadolinium in MRI a necessary part of the imaging test and is it safe?
Gadolinium is a contrast agent – a dye injected into the body to enhance images from the MRI. Gadolinium is a colorless, nonradioactive, water-like liquid. It is toxic but usually rapidly cleared by the kidneys. There has been some debate regarding the wisdom of using gadolinium in myeloma patients because of potential risks.

Is maintenance therapy necessary?
The issue of maintenance therapy following induction or "frontline" therapy is a thorny and unresolved one, and there is simply not enough clinical trial data available to establish guidelines. If you are referring to treatment given following stem cell transplant to "maintain" the gains made with high-dose therapy, even then maintenance therapy is a controversial and much-discussed topic, and we are far from having a definitive answer.
I’ve read that blood clots can be caused by a regimen of Revlimid® (lenalidomide) and dexamethasone. What can I do to guard against this?
As always, it is best to discuss this question with your own doctor. Your doctor is in the best position to decide whether you should be on Rev/dex, and if so, what medications you might need to help prevent blood clots based upon the drugs and dosages you are receiving and whether or not you are at a higher risk than average for blood clots.

What is Waldenström’s macroglobulinemia.
There is a specific disease called Waldenström's macroglobulinemia that is different from myeloma. What causes the confusion with myeloma is that Waldenström's macroglobulinemia also involves abnormal plasma cells and is characterized by excess monoclonal IgM proteins in the blood.
Is myeloma hereditary?
There is only a weak family tendency to develop myeloma. Approcimately 3-5% of patients with myeloma give a history of myeloma or a related blood/bone marrow condition within the extended family. Thus far, no specific gene has been linked to this myeloma tendency.

What is monoclonal gammopathy of undetermined significance (MGUS)?
Finding a MGUS means there is an abnormal protein detected in a blood test. Although it doesn't represent cancer, because those with a MGUS are at risk of developing MM or related disorders, lifelong monitoring is required.
What is a mini-allo transplant?
William Bensinger, MD explains this new approach, which is currently the subject of clinical trials.

What is nonsecretory myeloma?
Nonsecretory myeloma is characterized by the absence of an M protein in both the serum and urine.
How common is renal failure in myeloma patients?
Renal failure is present in approximately 20% of patients with multiple myeloma. Renal function impairment is usually caused by "myeloma kidney" and is reversible in 50% of patients, particularly when it is moderate and related to hypercalcemia.