Understanding
Dexamethasone
and
Other Steroids
International Myeloma Foundation
12650 Riverside Drive, Suite 206
North Hol ywood, CA 91607 USA
Telephone:
800-452-CURE (2873)
(USA & Canada)
818-487-7455
Fax: 818-487-7454
TheIMF@myeloma.org
www.myeloma.org

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Table of Contents
Introduction
5
What is Multiple Myeloma?
5
What are the Stages of Multiple Myeloma?
7
What is Dexamethasone, and
How Does it Work?
8
Dosages and Dose Scheduling Used
in Steroid Treatment
12
What Are Some Possible Side Effects
of Dexamethasone?
15
Can Other Drugs Interact
with Dexamethasone?
24
How Is Dexamethasone Given and
Are There Any Special Considerations
that Need to Be Noted When Taking
Dexamethasone?
26
Are Other Corticosteroids Used
in the Treatment of Multiple Myeloma?
27
About the IMF
29
Glossary
32
©2010, International Myeloma Foundation, North Hollywood, California (XI10)

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Introduction
You have been given this booklet to learn
more about a drug cal ed dexamethasone
as wel as other drugs within the same class
as dexamethasone: namely, the adrenal
corticosteroids (prednisone, prednisolone,
and methylprednisolone). These drugs are
used to treat multiple myeloma. After reading
this booklet, you should know the fol owing:
n What dexamethasone is
n How dexamethasone works
n The possible side ef ects of
dexamethasone
n How dexamethasone is given
n Similar details about the other adrenal
corticosteroids that are used in the treat-
ment of multiple myeloma
This booklet is meant to provide you with
general information only. It is not meant to
replace the advice of your doctor, nurse, or
other healthcare practitioner. Your health-
care team can answer questions related to
your specific treatment plan. Al words that
appear in bold type are defined in a glos-
sary at the end of this booklet.
What Is Multiple Myeloma?
Multiple myeloma (also known as myeloma
and plasma cel neoplasm) is a malignancy
of the immunoglobulin-producing plasma
cel s found in the bone marrow. It is a malig-
nancy that involves the immune system. The
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malignant plasma cel s, or myeloma cel s,
The Stages of Multiple Myeloma
rarely enter the blood stream. The myeloma
cel s accumulate in the bone marrow, caus-
Stage I (low cell mass): Early disease.
ing the fol owing:
The bone structure appears normal or close
to normal on x-ray images; the number of
n Disruption of normal bone marrow
red blood cel s and amount of calcium in the
function, most commonly causing ane-
blood are normal or close to normal; and the
mia (a low level of red blood cel s in the
amount of M protein is very low
bloodstream), although reduction in white
blood cel and platelet counts can also
Stage II (intermediate cell mass): An
occur
intermediate stage between stage I and I I
n Damage to bone surrounding accumu-
Stage III (high cell mass): More
lated myeloma cel s
advanced disease. One or more of the
n Release of an abnormal protein,
fol owing are present:
monoclonal protein (M protein), into
n Anemia
the bloodstream
n A high level of calcium in the blood
n Suppression of normal immune function,
n More than 3 areas of advanced lytic
observed as reduced levels of normal
bone lesions
immunoglobulins and increased
n A high level of M protein in the blood
susceptibility to infection
or urine
Myeloma cel s can also grow in the form
Multiple myeloma is a serious malignancy,
of localized tumors or plasmacytomas.
but it is treatable. Many patients experience
Plasmacytomas may be single or multiple
a series of responses, relapses, and remis-
and either medul ary (confined within bone
sions. New treatments may extend the aver-
marrow and bone) or extramedul ary (out-
age survival of 5 years or more for patients
side of the bone). When there are multiple
diagnosed with multiple myeloma.
plasmacytomas inside or outside bone, this
condition is also cal ed multiple myeloma.
Fol owing diagnosis, several options are
available for initial or front-line therapy.
Confronted with a diagnosis of multiple
For patients who may be candidates for
myeloma, it is important for your doctor to
high-dose therapy with transplant, vari-
determine the stage of the disease. Disease
ous induction regimens can be considered
staging wil help determine which parts of
including VELCADE® (bortezomib) with
the body have been af ected and to what
dexamethasone, Revlimid® (lenalidomide)
extent. This wil al ow the doctor to decide
with dexamethasone, thalidomide with
upon the best treatment option.
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dexamethasone, dexamethasone alone,
other dexamethasone-containing combina-
tions, or combinations containing other adre-
nocortical steroids. The combination of the
alkylating agent melphalan plus prednisone,
a simple oral therapy, is an option for patients
who are not considering transplant com-
bined with intravenous high-dose melphalan;
VELCADE®, Revlimid®, or thalidomide may
be added to melphalan plus prednisone to
improve response. At the time of relapse,
newer agents are frequently required to
achieve further response. Revlimid® and
VELCADE® are important new agents avail-
able for use in this set ing.
and normal immune responses. Synthetic ver-
sions can imitate the actions of the natural y
What Is Dexamethasone,
occurring compounds or replace them in con-
and How Does It Work?
ditions that are associated with insuf icient
production of much-needed steroids that are
Dexamethasone (also known by the brand
normal y produced by the adrenal glands.
names Decadron®, Dexasone®, Diodex®,
Hexadrol®, and Maxidex®) is one of the
Dexamethasone, a synthetic steroid, is avail-
medications used in the treatment of multiple
able in many forms. It is available as an
myeloma. It is a synthetic adrenocortical ste-
injection, in oral tablets, in solutions to treat
roid. Adrenocortical steroids, also known as
eye infections, in nasal sprays, and in topical
glucocorticosteroids or corticosteroids, are
forms as a gel, cream, and spray. The injec-
produced natural y by the adrenal glands
tion and tablets are used to treat multiple
in the body. To make things less confusing,
myeloma. Dexamethasone is used to treat a
these compounds wil be referred to as the
wide variety of medical conditions in addi-
steroids throughout this brochure.
tion to multiple myeloma. Some of these are
listed below:
Adrenal glands produce hormones and ste-
roids. The steroids influence many actions
n Endocrine disorders, including conditions
of the body's systems. They are involved in
in which the adrenal glands, for numerous
regulation of carbohydrates, proteins, and
reasons, do not produce enough steroids
fats. They also inhibit inflammatory, al ergic,
(known as adrenocortical insufficiency
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and adrenal hyperplasia); thyroid-
below the skin), and thrombocytopenia
itis (inflammation of the thyroid gland);
(low levels of platelets in the blood)
or hypercalcemia (abnormal y high levels
n Neoplastic diseases (malignancies), includ-
of calcium caused by cancer)
ing some types of leukemia, lymphoma,
n Rheumatic/col agen disorders, including
and myeloma
various types of arthritis, ankylosing spon-
n Edematous states, including numerous con-
dylitis (inflammation of the spine and the
ditions associated with swel ing through-
sacroiliac joints), systemic lupus erythe-
out the body
matosus (commonly referred to as lupus),
Dexamethasone and other steroids, par-
and scleroderma
ticularly prednisone, prednisolone, and
n Dermatologic diseases, including some
methylprednisolone, have many uses in the
types of rashes, redness of the skin, and
treatment of cancer. They suppress certain
mycosis fungoides (lymphoma involving
actions of the immune system and also inhibit
the skin)
cytokines, which are chemicals in the body
n Al ergic states, including those associated
that control inflammation. Dexamethasone
with asthma, dermatitis, drug hypersen-
decreases inflammation or swel ing by stop-
sitivity, perennial and seasonal al ergies,
ping white blood cel s, which normal y fight
and serum sickness
infection, from traveling to areas of the body
n Ophthalmic diseases, including a number
where there is swel ing. Its anti-inflammatory
of conditions that cause redness, swel ing,
actions can actual y stop the swel ing around
and inflammation of the eyes and sur-
tumors (especial y on the spine, brain, and
rounding parts of the eyes
n Gastrointestinal (GI) diseases, such
as enteritis (inflammation of the smal
intestine) and colitis (inflammation of the
large intestine)
n Respiratory diseases, including asthma,
chronic obstructive pulmonary disease,
some types of pneumonia, and sarcoidosis
(inflammation of the lymph nodes and
other organs)
n Hematologic disorders, including some
types of anemia, purpura (bleeding just
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bone) and the resulting pain and other
chemotherapeutic and immunomodulatory
symptoms caused by tumors pressing on
agents to destroy myeloma cel s. However,
nerve endings.
dexamethasone and other steroids are
Dexamethasone can also alter normal
sometimes used alone to treat the disease. In
immune system responses and is therefore
fact, dexamethasone, given in high doses, is
useful in the treatment of conditions that
the most active single agent for treatment of
af ect the immune system, such as certain
multiple myeloma. Treatment can sometimes
types of anemia (for example, aplastic ane-
bring about remission. Dexamethasone thus
mia and hemolytic anemia), thrombocytope-
offers several advantages and benefits.
nia, and purpura.
Response rates typical y are high with dexa-
methasone, but side effects can occur.
Dexamethasone typical y is given with other
agents ­ such as vincristine, doxorubicin,
Dosages and Dose Scheduling
VELCADE®, Revlimid®, and thalidomide ­ to
treat multiple myeloma. It has been found
Used in Steroid Treatment
that steroids can increase the ability of
Front-Line Therapy
Dexamethasone is typical y given alone ­
or in combination with another agent such
as thalidomide (Thalomid®), lenalidomide
(Revlimid®), or bortezomib (Velcade®) ­ as
front-line therapy for myeloma. It is most
often given oral y in 4-day pulses (usual y,
but not always, 40mg 4 days in a row with
a varying number of days of before the
next dose: for example, 4 days on/4 days
of ; 4 days on/10 days of ; 4 days on once
per month). Many oncologists are now pre-
scribing dexamethasone in a once-weekly
cycle, often at a dose lower than 40 mg.
Based upon recent ECOG trial data, the once
weekly dosing schedule is now more of a pre-
ferred approach. The ECOG trial evaluated
the Revlimid/dexamethasone (high- and low-
dose) combinations in the frontline set ing. The
once per week schedule "low-dose" proved
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to be more ef ective (bet er survival at 1 year)
Relapse Therapy
and had significantly fewer side ef ects. Results
Dexamethasone is most frequently used in
were presented at ASCO 2007. Your doctor
this set ing. The dosages and scheduling are
wil work with you to find a dosing schedule
as outlined for front-line approaches.
that is wel tolerated and appropriate to treat
your multiple myeloma.
What Are Some Possible Side
Maintenance Therapy
Effects of Dexamethasone?
The steroid most commonly used as main-
tenance therapy is prednisone. It is given
As is the case with any medication, use of
oral y at 50 mg every other day. As with
dexamethasone can cause some unwanted
dexamethasone, the dose of prednisone can
side ef ects. Few, if any patients, experience
be reduced. The goal is to determine a dos-
al of these side ef ects. In fact, some patients
age that wil maintain a patient's response
do not experience any side ef ects at al while
without causing side ef ects that compromise
taking dexamethasone. There are certain
quality of life. Your hematologist/oncologist
precautionary measures that patients and
wil work with you to determine a dose that
their healthcare team should take in order to
best suits your needs and tolerance.
reduce or avoid the adverse ef ects. The most
important side ef ects and precautions are
described here. Members of your healthcare
team can provide more information in greater
detail about these and other possible side
ef ects. They also can make recommendations
about managing these side ef ects if, and
when, they occur.
The chances of side effects caused by
steroids, including dexamethasone, increase
with length of treatment and dose of the medi-
cation. In other words, the longer you take the
drug and the higher the dose you are taking,
the greater are your chances of experiencing
side ef ects. Most of the side ef ects can be
reversed and wil go away when treatment is
completed. However, do not stop taking any
of your medications or reduce your doses on
your own. Speak to your healthcare team if
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you are experiencing any side ef ects or if you
have any questions.
Below are some of the more common and/
or more serious possible side ef ects (listed
by body system af ected), some precautions
worth remembering, and some tips on how
to avoid or manage adverse events.
Infections
Because steroids block white blood cel s
from reaching sites of infection, these agents
may cause existing infections to get worse or
al ow new infections to occur. A paradoxic
ef ect is that the white blood cel level in the
soon as they occur. Make sure you wash
blood increases because the cel s are not
your hands frequently, especial y after being
exiting the bloodstream to enter infected tis-
in public places.
sues. Any drugs that suppress normal immune
Patients who have never had chickenpox or
responses can make a person susceptible to
measles should be especial y careful to avoid
infections. Steroids may actual y mask signs
exposure. If you are exposed to either il ness,
that an infection is present. They may also
you should notify someone on your health-
decrease a person's ability to fight the start of
care team as soon as you become aware of
a new infection. Therefore, patients who are
the exposure. Patients taking dexamethasone
taking steroids, including dexamethasone,
or any steroids also should avoid being vac-
have an increased risk of al types of infec-
cinated. There are certain types of vaccine
tions (bacterial, viral, or fungal).
that may be given if real y needed. However,
Prevention and Treatment of Infections
consult with your healthcare team before you
Steroids, including dexamethasone, should
receive any vaccines for any reason. They
not be administered to a patient who has
can tel you if the vaccine in question is safe
a known infection. Nevertheless, there are
for you to take.
some situations in which steroids may be
Cardiac Conditions and Fluid Retention
important or necessary during the time that
Use of dexamethasone and other steroids can
an active infection is being treated with
cause increases in blood pressure, salt and
appropriate antibiotics.
water retention, and potassium and calcium
Any signs of an infection should be brought
excretion. These changes are more likely
to the at ention of your healthcare team as
to occur when the drugs are taken in large
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doses. Salt retention may lead to edema or
dexamethasone. Increased sweating is also
swel ing. You may notice that your ankles
seen in some patients during steroid therapy.
and feet are swol en. Fluid retention and loss
Prevention and Treatment of Dermatologic
of potassium can be a problem for patients
Conditions
who have cardiac conditions, especial y con-
Be careful when you cut or scratch yourself.
gestive heart failure and hypertension.
Proper hygiene is important. Wash any
Prevention and Treatment of Cardiac
wound and keep the area clean. If you
Conditions and Fluid Retention
notice that a cut or wound isn't healing
Changes in diet may be needed. You may
quickly or properly, you should cal someone
have to restrict your salt intake and take
on your healthcare team. Also, do not use
supplements to replace lost potassium and
any over-the-counter products to treat wounds
calcium. Speak with your healthcare team
before consulting with a member of your
who wil work with you to make sure that
healthcare team.
you are eating the right foods and taking the
Endocrine Effects
proper supplements.
Steroids, including dexamethasone, may
Dermatologic Effects
interfere with the way patients metabolize
Patients taking dexamethasone or other ste-
carbohydrates and can cause blood glucose
roids may notice that it takes longer than
levels to rise. This is especial y important
usual for wounds to heal. Patients also
in patients who have diabetes. Patients
may develop acne and rashes while taking
with known diabetes can take steroids.
However, additional treatment, including insu-
lin therapy, may be needed to control blood
sugar levels.
Steroids can also cause menstrual irregularities.
Prevention and Treatment of Endocrine Effects
Patients with diabetes may need to monitor
their blood glucose levels more frequently.
These patients may need to adjust the doses
of their insulin or diabetes medications.
However, this decision needs to be made by
healthcare professionals and not by patients
themselves. If you have diabetes, let the doc-
tor who is treating your diabetes know that
you are taking dexamethasone.
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Patients of childbearing age should be
hiccups may require such prescription drugs
advised that the ef ects of steroids on the
as Thorazine® or Phenergan®. If you experi-
developing child are unknown. Therefore,
ence any GI adverse ef ects while taking
women, especial y those experiencing men-
dexamethasone, you should tel someone on
strual irregularities, should take added pre-
your healthcare team. They can of er advice
cautions not to become pregnant while
on how to manage or avoid these unpleas-
taking dexamethasone.
ant ef ects.
Gastrointestinal Effects
General Effects
Steroids can have various effects on your
Use of steroids, including dexamethasone,
GI tract. They increase the risk of GI per-
can cause weight gain.
forations. Therefore, patients who have
peptic ulcers, diverticulitis, and ulcerative
Some patients may experience several days
colitis should use corticosteroids cautiously
of hoarseness. Usual y this side ef ect wears
to minimize the risk of perforation. For these
of , but it may linger in patients who are tak-
reasons, many physicians automatical y rec-
ing frequent 4-day pulses of dexamethasone.
ommend antacid therapy of some type for
Resting the voice can help with this condition.
patients taking steroids (eg, Pepsid®).
Prevention and Treatment of Weight Gain
Other possible GI side effects seen with
Some weight gain is to be expected dur-
dexamethasone therapy are increased or
ing steroid therapy. Dexamethasone has
decreased appetite, stomach bloating, nau-
a tendency to increase patients' appetites.
sea, vomiting, hiccups, and heartburn.
Patients need to control their caloric intake.
Prevention and Treatment of Gastrointestinal
Reduced carbohydrate intake is especial y
Effects
helpful during steroid therapy. However, if
To avoid or minimize GI irritation, dexa-
there is a sudden, large weight gain (more
methasone should be taken with food or
than 5 lbs over a day or two), you should
after meals. Alcoholic beverages, which
let your healthcare team know immediately.
also irritate the stomach, should be avoided
Musculoskeletal Effects
while taking dexamethasone. Limiting intake
Because steroids decrease calcium absorp-
of caf eine-containing foods and drinks (such
tion and increase its excretion, they af ect
as colas, cof ee, tea, and chocolate) may
bones. These ef ects can lead to pain and
also help. Eating smal , frequent meals may
osteoporosis in adults. Therefore, patients
decrease nausea. Antacids taken between
most at risk for osteoporosis, especial y
meals may also be helpful but should not
postmenopausal women, should be cau-
be taken unless approved by someone on
tious when taking large doses of steroids
the healthcare team. Treatment for persistent
over long periods of time. You may also
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experience muscle pains because you may
Many patients with myeloma take bisphos-
be losing potassium.
phonate therapy as treatment for myeloma-
Prevention and Treatment of Musculoskeletal
related bone disease. This bisphosphonate
Effects
therapy also combats the negative ef ects of
You may have to take some type of supple-
steroids upon bone strength and density.
ments to replace the calcium and potassium
Ophthalmologic Effects
you are losing. Do not take any supplements
Prolonged steroid treatment may produce
on your own, however. You can increase
cataracts, elevated intraocular pressure that
your calcium intake by eating foods that
could lead to glaucoma, optic nerve dam-
have high calcium content. Foods such as
age, and eye infections.
milk, cheese, yogurt, and other dairy prod-
Prevention and Treatment of Ophthalmologic
ucts and some vegetables are calcium rich
Effects
foods. Bananas and some other fruits and
Have your eyes checked regularly. Any
vegetables can be good sources of potas-
change in vision should be reported immedi-
sium. Consult with a member of your health-
ately to your healthcare team.
care team first, however, before you start
taking any supplements or change your diet.
Psychiatric and Neurologic Effects
Steroids can also cause irritability, mood
swings, personality changes, and severe
depression. They also can cause insomnia.
Emotional instability or psychotic tendencies
are aggravated and may become worse dur-
ing steroid therapy.
Patients also have reported experiencing
headaches and dizziness.
Prevention and Treatment of Psychiatric and
Neurologic Effects
Contact someone on your healthcare team
if you are experiencing any of the mood
or personality ef ects listed above. Family
members should be advised that you may be
more irritable and dif icult to live with when
you are receiving steroid therapy. If you are
having problems sleeping, ask a member of
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your healthcare team if you can adjust the
as wel as other medical conditions that also
time you take dexamethasone so it doesn't
may be present. Chances of drug interac-
interfere with your sleep during the night.
tions increase with multiple medications.
Regular sleep medications can be helpful
Below is a list of some (but not al ) medica-
and necessary for some patients.
tions or classes of medications that may inter-
Al ergic Reactions
act with dexamethasone. These interactions
Al ergic and hypersensitivity reactions
may increase or decrease the actions of any
to steroids are possible in patients who
of the drugs. This is why it's important to tel
are susceptible or have had al ergic
al members of your healthcare team about
responses to other drugs. Al ergic reactions
al the prescription and over-the-counter med-
can include dif iculty breathing, closing of
ications, as wel as herbal preparations and
the throat, swel ing of lips and tongue, and
vitamins that you are taking.
hives. Such al ergic reactions to steroids are
Drugs That Can Interact with Dexamethasone and
exceedingly rare.
Other Corticosteroids
Prevention and Treatment of Al ergic Reactions
n Amphotericin B and diuretics that af ect
Special precaution should be used before
potassium levels, such as amiloride, spi-
administering dexamethasone or any other
ronolactone, and triamterene
corticosteroid to patients who have histories
n Antibiotics, such as erythromycin, clarithro-
of any type of al ergic reactions to medica-
mycin, rifampicin, and azithromycin
tions. Be sure to alert your healthcare team
n Anticoagulant medications, such as warfa-
if you have a history of al ergic responses
rin and aspirin
when given any medication.
n Barbiturates, such as amobarbital, butal-
Remember: speak with your doctor,
bital, pentobarbital, and secobarbital
nurse, or someone else on your
n Diabetes medications, such as insulin,
healthcare team if you notice any
glibenclamide, metformin
changes in your health.
n Cyclosporine
Can Other Drugs Interact
n Digitalis
with Dexamethasone?
n Ephedrine, which is most commonly found
in weight-loss products
Interactions with other medications are defi-
n Estrogen-containing medications, includ-
nitely possible with dexamethasone. Patients
ing oral contraceptives and hormone-
with multiple myeloma typical y need to take
replacement therapy products
a number of medications to treat the disease
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n Nonsteroidal anti-inflammatory drugs
drugs gradual y. Abrupt discontinuation can
(NSAIDs), including aspirin, ibuprofen,
lead to withdrawal symptoms.
indomethacin, and naproxen
Your healthcare team wil manage how
n Phenytoin
dexamethasone is administered to avoid
or minimize adverse effects as much
How Is Dexamethasone Given
as possible.
and Are There Any Special
Considerations That Need
Are Other Corticosteroids Used
to Be Noted When Taking
in the Treatment of Multiple
Dexamethasone?
Myeloma?
Dexamethasone typical y is given in an
In addition to dexamethasone, other cortico-
infusion or oral y, either with other anti-
steroids often are used to treat patients with
cancer agents or alone, to treat multiple
multiple myeloma. These drugs are listed
myeloma. The amount of dexamethasone
below.
patients receive depends on many factors.
Name
However, to reduce the chances of side
Brand Names
of Corticosteroid
ef ects, the smal est dose necessary of dexa-
Prednisone
Deltasone®, Liquid Pred®, Meticorten®,
methasone that can produce the desired
Orasone®, Prednicen-M®, Sterapred®,
response should be used. Doses of dexa-
Sterapred DS®
methasone are decided by members of the
Prednisolone
Orapred®, Pediapred®, Prelone®
healthcare team who are familiar with each
Methylprednisolone
Duralone®, Mediapred®, Medralone®,
patient's medical history and case.
Medrol®, Predacorten®, Solu-Medrol®
Dexamethasone can irritate the stomach;
Because these drugs al belong to the same
taking it with food can reduce the chances
class of drugs ­ namely, the glucocortico-
of this happening. Alcohol should be used
steroids ­ they act very similarly and can
cautiously or avoided altogether while taking
be used to treat many of the same medical
dexamethasone, as alcohol and dexametha-
conditions. They behave the same way
sone together can damage the stomach
chemical y in the body to treat diseases.
lining.
Also, because they are so similar in their
As with other glucocorticosteroids, dexa-
mechanisms of action, many of the side
methasone therapy cannot be stopped
ef ects and associated precautions are the
abruptly. It is necessary to stop this group of
same. Results of clinical trials have shown
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these agents al to be equal y ef ective in the
About the IMF
treatment of multiple myeloma.
"One person can make a dif erence,
The uses, side ef ects, precautions, and con-
Two can make a miracle."
siderations described previously for dexa-
Brian D. Novis
methasone are relevant for the entire class
IMF Founder
of corticosteroids and thus pertain to pred-
nisone, prednisolone, and methylpredniso-
Myeloma is a lit le-known, complex, and
lone. Prednisolone is actual y a metabolite of
often misdiagnosed bone marrow cancer
prednisone. Methylprednisolone, although
that at acks and destroys bone. Myeloma
structural y similar, may be less toxic and
af ects approximately 75,000 to 100,000
appears to be associated with less sodium
people in the United States, with more than
and fluid retention than prednisolone. Thus, it
20,000 new cases diagnosed each year.
is worth discussing with the healthcare team
Although there is presently no known cure for
if any particular type of steroid (eg, methyl-
myeloma, doctors have many approaches to
help myeloma patients live bet er and longer.
prednisolone vs dexamethasone) might be
more useful or appropriate in your care.
The International Myeloma Foundation (IMF)
As with dexamethasone, the smal est dose
was founded in 1990 by Brian and Susie
necessary of the corticosteroids that can
Novis shortly after Brian's myeloma diagno-
produce the desired response should be used
sis at the age of 33. It was Brian's dream
in order to avoid or minimize unwanted side
that future patients would have easy access
to medical information and emotional sup-
ef ects.
port throughout their bat le with myeloma.
For more information on multiple myeloma
He established the IMF with the three goals
and treatment options, contact the IMF.
of treatment, education, and research. He
sought to provide a broad spectrum of ser-
IMF Hotline:
vices for patients and, their families, friends,
and healthcare providers. Although Brian
USA & Canada only: 800-452-CURE (2873)
died four years after his initial diagnosis, his
Elsewhere: 818-487-7455
dream did not. Today, the IMF reaches out
IMF Web site: www.myeloma.org
to an international membership of more than
195,000. The IMF was the first organization
dedicated solely to myeloma, and today it
remains the largest.
The IMF provides programs and services to
aid in the research, diagnosis, treatment,
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and management of myeloma. The IMF
IMF PATIENT & FAMILy sEMINARsTM
ensures that no one must brave the myeloma
Meet with leading experts in myeloma treat-
bat le alone.
ment to learn more about recent advances in
therapy and research.
We care for patients today, while working
toward tomorrow's cure.
MyELOMA MATRIxTM
On our website and in print, this document is a
How Can the IMF Help You?
comprehensive guide to drugs in development
for myeloma.
PATIENT EDUCATION
MyELOMA TODAyTM NEwsLETTER
INFORMATION PACkAGE
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Our free IMF InfoPackTM provides compre-
charge by subscription.
hensive information about myeloma, treat-
ment options, disease management, and IMF
sUPPORT
services. It includes our acclaimed Patient
MyELOMA HOTLINE: 800-452-CURE (2873)
Handbook.
Toll-free throughout the United States and
INTERNET ACCEss
Canada, the IMF Hotline is staf ed by trained
Log on to www.myeloma.org for 24-hour
information specialists and is in frequent
access to information about myeloma, the IMF,
interaction with members of our Scientific
education, and support programs.
Advisory Board.
MyELOMA MANAGERTM PERsONAL CARE AssIsTANTTM
sUPPORT GROUPs
This software program was developed by
A worldwide network of more than 100
the IMF and is designed specifical y to help
myeloma support groups hold regular meetings
patients and caregivers to capture, display,
for members of the myeloma community. The
and store laboratory test results, and to access
IMF conducts annual retreats for leaders of
important information. It is available free of
myeloma support group leaders.
charge on the IMF website at www.myeloma.
REsEARCH
org. Currently this program is only compatible
BANk ON A CURE®
with PCs.
This DNA bank wil provides genetic data
ONLINE MyELOMA FORUM
research in new drug development.
Join the IMF Internet Discussion Group at
THE INTERNATIONAL sTAGING sysTEM (Iss)
www.myeloma.org/listserve.html to share your
This updated staging system for myeloma
thoughts and experiences.
enhances physicians' ability to select the most
MyELOMA MINUTETM
appropriate treatment for each patient.
Subscribe to this free weekly email news-
REsEARCH GRANTs
let er for up-to-the-minute information about
Leading the world in col aborative research
myeloma.
and achieving extraordinary results, the IMF
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Grant Program supports both junior and senior
Enteritis: Irritation or inflammation of the smal intes-
researchers working on a broad spectrum of
tine.
projects. The IMF has at racted many young
Hematologic malignancy: A cancer of the blood or bone
investigators into the field of myeloma; they
marrow.
have remained in the field and are actively
Immunoglobulin: An antibody.
pursuing a cure for this disease.
Immunomodulatory agent: Drug that af ects, enhances,
or suppresses the immune system.
Glossary
Lytic bone lesion: Dissolution or destruction of bone
Alkylating agent: An agent that prevents the growth
cel s leading to holes in bone.
and division of new cancer cel s by inhibiting their
Metabolite: A substance that is the product of the
ability to replicate DNA.
metabolism of another substance known as a parent
Adrenocortical steroid: Any of the steroidal hormones
compound
produced by the adrenal cortex or their synthetic
Monoclonal protein (M protein): An abnormal protein
equivalents. Also known as adrenocorticoids, gluco-
produced by myeloma cel s that accumulate in and
corticosteroid, or corticosteroid.
damages bone and bone marrow. A high level of M
Alkylating agent: An agent that prevents the growth
protein indicates that myeloma cel s are present in
and division of new cancer cel s by inhibiting their
large numbers.
ability to replicate DNA.
Multiple myeloma: A cancer arising from the plasma
Ankylosing spondylitis: A form of chronic inflammation
cel s in the bone marrow. The plasma cel s in patients
of the spine and the sacroiliac joints.
with multiple myeloma form abnormal antibodies,
possibly damaging the bone, bone marrow and
Antibody: A protein produced by some of the body's
other organs.
white blood cel s that helps fight infection.
Mycosis fungoides: A blood lymphoma that stays
Apoptosis: The programmed death of a cel ; believed
mostly in the skin and causes a rash.
to be governed by chemical signals a given cel
receives.
Plasma cell: A type of white blood cel that produces
antibodies.
Bone marrow: A soft spongy tissue found in most large
bones that produces red and white blood cel s and
Plasmacytoma: A tumor made up of cancerous plasma
platelets.
cel s.
Cell: The smal est unit of life. Mil ions of microscopic
Platelet: An element in the blood that helps with
cel s comprise each body organ.
clot ing, which in turn helps repair damaged blood
vessels.
Colitis: Inflammation of the lining of the large intes-
tine.
Protein: A group of compounds that are the main
components of a cel .
Cytokine: A growth factor produced by T-cel s that
stimulates the growth of T cel s and B cel s.
Purpura: Bleeding that occurs just below the skin that
causes purple spots and patches to appear because
Edematous: Swol en with an excessive accumulation
of the leakage of blood into the tissues under the skin
of fluid.
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Red blood cell: A blood cel that carries oxygen from
the lungs throughout the body.
Sarcoidosis: An inflammation of the lymph nodes and
other organs.
Scleroderma: A connective tissue disorder character-
ized by tightening of the skin of the arms, face or
hands, puf y hands and feet, and joint stif ness and
pain that can af ect one part of the body or the
entire body.
Serum sickness: A hypersensitive reaction caused
by the administration of a foreign serum; it causes
fever, swel ing, skin rash, and enlargement of the
lymph nodes.
Side effect: An ef ect caused by the treatment with a
drug. The term usual y refers to an unwanted ef ect,
but some side ef ects may be beneficial.
Systemic lupus erythematosus (SLE): A chronic, inflam-
matory autoimmune disorder that can af ect the skin,
joints, kidneys, and other organs.
Thrombocytopenia: A low level of platelets in the
blood. These low levels can cause bruising or bleed-
ing as wel as delay in the injury healing process.
Topical: pertaining to body surfaces such as the skin
or mucous membranes
White blood cell: A cel made by the bone marrow that
helps fight infection and/or disease.
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