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
9/07
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
13
What Are Some Possible Side Effects
of Dexamethasone?
15
Can Other Drugs Interact
with Dexamethasone?
25
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
©2007, International Myeloma Foundation, North Hollywood, California
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 health-care 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
4
5
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. For
Confronted with a diagnosis of multiple
patients who may be candidates for high-dose
myeloma, it is important for your doctor to
therapy with transplant, various induction
determine the stage of the disease. Disease
regimens can be considered including thalid-
staging wil help determine which parts of
omide with dexamethasone, dexamethasone
the body have been af ected and to what
alone, other dexamethasone-containing com-
extent. This wil al ow the doctor to decide
binations, or combinations containing other
upon the best treatment option.
6
7
myeloma. It is a synthetic adrenocortical ste-
roid. Adrenocortical steroids, also known as
glucocorticosteroids or corticosteroids, are
produced natural y by the adrenal glands
in the body. To make things less confusing,
these compounds wil be referred to as the
steroids throughout this brochure.
Adrenal glands produce hormones and ste-
roids. The steroids influence many actions
of the body's systems. They are involved in
regulation of carbohydrates, proteins, and
fats. They also inhibit inflammatory, al ergic,
and normal immune responses. Synthetic ver-
sions can imitate the actions of the natural y
occurring compounds or replace them in con-
ditions that are associated with insuf icient
production of much-needed steroids that are
adrenocortical steroids. The combination of
normal y produced by the adrenal glands.
the alkylating agent melphalan plus pred-
Dexamethasone, a synthetic steroid, is avail-
nisone, a simple oral therapy, is an option
able in many forms. It is available as an
for patients who are not considering trans-
injection, in oral tablets, in solutions to treat
plant combined with intravenous high-dose
eye infections, in nasal sprays, and in topical
melphalan. At the time of relapse, newer
forms as a gel, cream, and spray. The injec-
agents are frequently required to achieve fur-
tion and tablets are used to treat multiple
ther response. Revlimid® (lenalidomide) and
myeloma. Dexamethasone is used to treat a
Velcade® (bortezomib) are important new
wide variety of medical conditions in addi-
agents available for use in this set ing.
tion to multiple myeloma. Some of these are
listed below:
What Is Dexamethasone, and How
n Endocrine disorders, including conditions
Does It Work?
in which the adrenal glands, for numer-
Dexamethasone (also known by the brand
ous reasons, do not produce enough
names Decadron®, Dexasone®, Diodex®,
steroids (known as adrenocortical insuf-
Hexadrol®, and Maxidex®) is one of the
ficiency and adrenal hyperplasia); thy-
medications used in the treatment of multiple
roiditis (inflammation of the thyroid gland);
8
9
or hypercalcemia (abnormal y high levels
n Neoplastic diseases (malignancies), includ-
of calcium caused by cancer)
ing some types of leukemia, lymphoma,
and myeloma
n Rheumatic/col agen disorders, including
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
where there is swel ing. Its anti-inflammatory
n Ophthalmic diseases, including a number
actions can actual y stop the swel ing around
of conditions that cause redness, swel ing,
tumors (especial y on the spine, brain, and
and inflammation of the eyes and sur-
bone) and the resulting pain and other
rounding parts of the eyes
symptoms caused by tumors pressing on
n Gastrointestinal (GI) diseases, such
nerve endings.
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
below the skin), and thrombocytopenia
(low levels of platelets in the blood)
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11
Dexamethasone can also alter normal
It has been found that steroids can increase
immune system responses and is therefore
the ability of chemotherapeutic and immu-
useful in the treatment of conditions that
nomodulatory agents to destroy myeloma
af ect the immune system, such as certain
cel s. However, dexamethasone and other
types of anemia (for example, aplastic ane-
steroids are sometimes used alone to treat
mia and hemolytic anemia), thrombocytope-
the disease. In fact, dexamethasone, given
nia, and purpura.
in high doses, is the most active single
Dexamethasone is useful in the treatment
agent for treatment of multiple myeloma.
of blood disorders and malignancies such
Treatment can sometimes bring about remis-
as multiple myeloma. It appears to cause
sion. Dexamethasone thus of ers several
programmed cel death, also known as
advantages and benefits. Response rates
apoptosis. This means that steroids such as
typical y are high with dexamethasone, but
dexamethasone can trigger the destruction
side effects can occur.
of myeloma cel s.
Dosages and Dose Scheduling
Dexamethasone typical y is given with other
agents such as vincristine, doxorubicin,
Used in Steroid Treatment
and thalidomide to treat multiple myeloma.
Front-Line Therapy
Dexamethasone is typical y given alone or in
combination with another agent such as thalid-
omide (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 oncolo-
gists are now prescribing 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 preferred approach. The ECOG
trial evaluated the Revlimid/dexamethasone
(high- and low- dose) combinations in the
12
13
frontline set ing. The once per week schedule
Relapse Therapy
"low-dose" proved to be more ef ective (bet er
Dexamethasone is most frequently used in
survival at 1 year) and had significantly fewer
this set ing. The dosages and scheduling are
side ef ects. Results were presented at ASCO
as outlined for front-line approaches.
2007. Your doctor wil work with you to find
a dosing schedule that is wel tolerated and
What Are Some Possible Side
appropriate to treat your multiple myeloma.
Effects of Dexamethasone?
Maintenance Therapy
The steroid most commonly used as main-
As is the case with any medication, use of
tenance therapy is prednisone. It is given
dexamethasone can cause some unwanted
oral y at 50 mg every other day. As with
side ef ects. Few, if any patients, experience
dexamethasone, the dose of prednisone can
al of these side ef ects. In fact, some patients
be reduced. The goal is to determine a dos-
do not experience any side ef ects at al while
age that wil maintain a patient's response
taking dexamethasone. There are certain
without causing side ef ects that compromise
precautionary measures that patients and
quality of life. Your hematologist/oncologist
their health-care team should take in order to
wil work with you to determine a dose that
reduce or avoid the adverse ef ects. The most
best suits your needs and tolerance.
important side ef ects and precautions are
described here. Members of your health-care
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 health-care team if
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15
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
soon as they occur. Make sure you wash
ef ect is that the white blood cel level in the
your hands frequently, especial y after being
blood increases because the cel s are not
in public places.
exiting the bloodstream to enter infected tis-
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
care team as soon as you become aware of
of a new infection. Therefore, patients who
the exposure. Patients taking dexamethasone
are taking steroids, including dexametha-
or any steroids also should avoid being vac-
sone, have an increased risk of al types of
cinated. There are certain types of vaccine
infections (bacterial, viral, or fungal).
that may be given if real y needed. However,
consult with your health-care team before
Prevention and Treatment of Infections
you receive any vaccines for any reason.
Steroids, including dexamethasone, should
They can tel you if the vaccine in question is
not be administered to a patient who has
safe for you to take.
a known infection. Nevertheless, there are
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
an active infection is being treated with
can cause increases in blood pressure, salt
appropriate antibiotics.
and water retention, and potassium and cal-
cium excretion. These changes are more like-
Any signs of an infection should be brought
ly to occur when the drugs are taken in large
to the at ention of your health-care team as
16
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doses. Salt retention may lead to edema or
Endocrine Effects
swel ing. You may notice that your ankles
Steroids, including dexamethasone, may inter-
and feet are swol en. Fluid retention and loss
fere with the way patients metabolize carbo-
of potassium can be a problem for patients
hydrates and can cause blood glucose levels
who have cardiac conditions, especial y con-
to rise. This is especial y important in patients
gestive heart failure and hypertension.
who have diabetes. Patients with known dia-
Prevention and Treatment of Cardiac
betes can take steroids. However, additional
Conditions and Fluid Retention
treatment, including insulin therapy, may be
Changes in diet may be needed. You may
needed to control blood sugar levels.
have to restrict your salt intake and take
Steroids can also cause menstrual irregularities.
supplements to replace lost potassium and
calcium. Speak with your health-care team
Prevention and Treatment of Endocrine Effects
Patients with diabetes may need to monitor
who wil work with you to make sure that
their blood glucose levels more frequently.
you are eating the right foods and taking the
These patients may need to adjust the doses
proper supplements.
of their insulin or diabetes medications.
Dermatologic Effects
However, this decision needs to be made by
Patients taking dexamethasone or other ste-
health-care professionals and not by patients
roids may notice that it takes longer than
themselves. If you have diabetes, let the doc-
usual for wounds to heal. Patients also may
tor who is treating your diabetes know that
develop acne and rashes while taking dexa-
you are taking dexamethasone.
methasone. Increased sweating is also seen
in some patients during steroid therapy.
Prevention and Treatment of Dermatologic
Conditions
Be careful when you cut or scratch yourself.
Proper hygiene is important. Wash any
wound and keep the area clean. If you
notice that a cut or wound isn't healing
quickly or properly, you should cal someone
on your health-care team. Also, do not use
any over-the-counter products to treat wounds
before consulting with a member of your
health-care team.
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Patients of childbearing age should be
the health-care team. Treatment for persistent
advised that the ef ects of steroids on the
hiccups may require such prescription drugs
developing child are unknown. Therefore,
as Thorazine® or Phenergan®. If you experi-
women, especial y those experiencing men-
ence any GI adverse ef ects while taking
strual irregularities, should take added pre-
dexamethasone, you should tel someone on
cautions not to become pregnant while tak-
your health-care team. They can of er advice
ing dexamethasone.
on how to manage or avoid these unpleas-
Gastrointestinal Effects
ant ef ects.
Steroids can have various ef ects on your GI
General Effects
tract. They increase the risk of GI perfora-
Use of steroids, including dexamethasone,
tions. Therefore, patients who have pep-
can cause weight gain.
tic ulcers, diverticulitis, and ulcerative coli-
Some patients may experience several days of
tis should use corticosteroids cautiously to
hoarseness. Usual y this side ef ect wears of ,
minimize the risk of perforation. For these
but it may linger in patients who are taking fre-
reasons, many physicians automatical y rec-
quent 4-day pulses of dexamethasone. Resting
ommend antacid therapy of some type for
the voice can help with this condition.
patients taking steroids (eg, Pepsid®).
Prevention and Treatment of Weight Gain
Other possible GI side ef ects 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 2), you should let
after meals. Alcoholic beverages, which
your health-care 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 cautious
be taken unless approved by someone on
20
21
when taking large doses of steroids over
Psychiatric and Neurologic Effects
long periods of time. You may also experi-
Steroids can also cause irritability, mood
ence muscle pains because you may be
swings, personality changes, and severe
losing potassium.
depression. They also can cause insomnia.
Prevention and Treatment of Musculoskeletal
Emotional instability or psychotic tendencies
Effects
are aggravated and may become worse dur-
You may have to take some type of supple-
ing steroid therapy.
ments to replace the calcium and potassium
Patients also have reported experiencing
you are losing. Do not take any supplements
headaches and dizziness.
on your own, however. You can increase
your calcium intake by eating foods that
Prevention and Treatment of Psychiatric and
have high calcium content. Foods such as
Neurologic Effects
Contact someone on your health-care team
milk, cheese, yogurt, and other dairy prod-
if you are experiencing any of the mood
ucts and some vegetables are calcium rich
or personality ef ects listed above. Family
foods. Bananas and some other fruits and
members should be advised that you may be
vegetables can be good sources of potas-
more irritable and dif icult to live with when
sium. Consult with a member of your health-
you are receiving steroid therapy. If you are
care team first, however, before you start tak-
having problems sleeping, ask a member of
ing any supplements or change your diet.
your health-care team if you can adjust the
Many patients with myeloma take bisphos-
time you take dexamethasone so it doesn't
phonate therapy as treatment for myeloma-
interfere with your sleep during the night.
related bone disease. This bisphosphonate
Regular sleep medications can be helpful
therapy also combats the negative ef ects of
and necessary for some patients.
steroids upon bone strength and density.
Al ergic Reactions
Ophthalmologic Effects
Al ergic and hypersensitivity reactions
Prolonged steroid treatment may produce
to steroids are possible in patients who
cataracts, elevated intraocular pressure that
are susceptible or have had al ergic respons-
could lead to glaucoma, optic nerve dam-
es to other drugs. Al ergic reactions can
age, and eye infections.
include dif iculty breathing, closing of the
Prevention and Treatment of Ophthalmologic
throat, swel ing of lips and tongue, and
Effects
hives. Such al ergic reactions to steroids are
Have your eyes checked regularly. Any
exceedingly rare.
change in vision should be reported immedi-
ately to your health-care team.
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23
Can Other Drugs Interact
with Dexamethasone?
Interactions with other medications are defi-
nitely possible with dexamethasone. Patients
with multiple myeloma typical y need to take
a number of medications to treat the disease
as wel as other medical conditions that also
may be present. Chances of drug interactions
increase with multiple medications. Below is
a list of some (but not al ) medications or
classes of medications that may interact
with dexamethasone. These interactions may
increase or decrease the actions of any of
the drugs. This is why it's important to tel al
members of your health-care team about al
the prescription and over-the-counter medica-
tions, as wel as herbal preparations and
vitamins that you are taking.
Drugs That Can Interact with Dexamethasone and
Prevention and Treatment of Al ergic
Other Corticosteroids
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
of any type of al ergic reactions to medica-
n Antibiotics, such as erythromycin, clarithro-
tions. Be sure to alert your health-care team
mycin, rifampicin, and azithromycin
if you have a history of al ergic responses
n Anticoagulant medications, such as warfa-
when given any medication.
rin and aspirin
Remember: speak with your doc-
n Barbiturates, such as amobarbital, butal-
tor, nurse, or someone else on your
bital, pentobarbital, and secobarbital
health-care team if you notice any
n Diabetes medications, such as insulin,
changes in your health.
glibenclamide, metformin
n Cyclosporine
24
25
n Digitalis
dexamethasone, as alcohol and dexametha-
n Ephedrine, which is most commonly found
sone together can damage the stomach
in weight-loss products
lining.
n Estrogen-containing medications, including
As with other glucocorticosteroids, dexameth-
oral contraceptives and hormone- replace-
asone therapy cannot be stopped abruptly.
ment therapy products
It is necessary to stop this group of drugs
n Nonsteroidal anti-inflammatory drugs
gradual y. Abrupt discontinuation can lead
(NSAIDs), including aspirin, ibuprofen,
to withdrawal symptoms.
indomethacin, and naproxen
Your health-care 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
Brand Names
of Corticosteroid
However, to reduce the chances of side
ef ects, the smal est dose necessary of dexa-
Prednisone
Deltasone®, Liquid Pred®, Meticorten®,
Orasone®, Prednicen-M®, Sterapred®,
methasone that can produce the desired
Sterapred DS®
response should be used. Doses of dexa-
Prednisolone
Orapred®, Pediapred®, Prelone®
methasone are decided by members of the
health-care team who are familiar with each
Methylprednisolone
Duralone®, Mediapred®, Medralone®,
Medrol®, Predacorten®, Solu-Medrol®
patient's medical history and case.
Because these drugs al belong to the same
Dexamethasone can irritate the stomach;
class of drugs namely, the glucocortico-
taking it with food can reduce the chances
steroids they act very similarly and can
of this happening. Alcohol should be used
be used to treat many of the same medical
cautiously or avoided altogether while taking
conditions. They behave the same way
26
27
chemical y in the body to treat diseases.
About the IMF
Also, because they are so similar in their
mechanisms of action, many of the side
"One person can make a dif erence,
ef ects and associated precautions are the
Two can make a miracle."
same. Results of clinical trials have shown
Brian D. Novis
these agents al to be equal y ef ective in the
IMF Founder
treatment of multiple myeloma.
Myeloma is a lit le-known, complex, and
The uses, side ef ects, precautions, and con-
often misdiagnosed bone marrow cancer
siderations described previously for dexa-
that at acks and destroys bone. Myeloma
methasone are relevant for the entire class
af ects approximately 75,000 to 100,000
of corticosteroids and thus pertain to pred-
people in the United States, with more than
nisone, prednisolone, and methylpredniso-
20,000 new cases diagnosed each year
lone. Prednisolone is actual y a metabolite of
according to recent data. While there is
prednisone. Methylprednisolone, although
presently no known cure for myeloma, doc-
structural y similar, may be less toxic and
tors have many approaches to help myeloma
appears to be associated with less sodium
patients live bet er and longer.
and fluid retention than prednisolone. Thus, it
The International Myeloma Foundation (IMF)
is worth discussing with the health-care team
was founded in 1990 by Brian and Susie
if any particular type of steroid (eg, methyl-
Novis shortly after Brian's myeloma diagno-
prednisolone vs dexamethasone) might be
sis at the age of 33. It was Brian's dream that
more useful or appropriate in your care.
future patients would have easy access to
As with dexamethasone, the smal est dose
medical information and emotional support
necessary of the corticosteroids that can
throughout their bat le with myeloma. He
produce the desired response should be used
established the IMF with the 3 goals of treat-
in order to avoid or minimize unwanted side
ment, education, and research. He sought
ef ects.
to provide a broad spectrum of services for
For more information on multiple myeloma
patients, their families, friends, and health
and treatment options, contact the IMF.
care providers. Although Brian died 4 years
after his initial diagnosis, his dream didn't.
IMF hotline:
Today the IMF reaches out to an international
membership of more than 165,000. The IMF
USA & Canada only: 800-452-CURE (2873)
was the first organization dedicated solely to
Elsewhere: 818-487-7455
myeloma, and today it remains the largest.
IMF Web site: www.myeloma.org
28
29
The IMF provides programs and services to
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ensures that no one must brave the myeloma
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bat le alone.
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We care for patients today, while working
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information specialists and is in frequent inter-
How Can the IMF Help You?
action with members of our Scientific Advisory
Board.
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MYELOMA MATRIX
they have remained in the field and are actively
On our website and in print, this document is a
pursuing a cure for this disease.
comprehensive guide to drugs in development
for myeloma.
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Glossary
Alkylating agent: An agent that prevents the growth and
Monoclonal protein (M protein): An abnormal protein pro-
division of new cancer cel s by inhibiting their ability to
duced by myeloma cel s that accumulate in and damages
replicate DNA.
bone and bone marrow. A high level of M protein indi-
Adrenocortical steroid: Any of the steroidal hormones pro-
cates that myeloma cel s are present in large numbers.
duced by the adrenal cortex or their synthetic equivalents.
Multiple myeloma: A cancer arising from the plasma cel s
Also known as adrenocorticoids, glucocorticosteroid, or
in the bone marrow. The plasma cel s in patients with
corticosteroid.
multiple myeloma form abnormal antibodies, possibly
Alkylating agent: An agent that prevents the growth and
damaging the bone, bone marrow and other organs.
division of new cancer cel s by inhibiting their ability to
Mycosis fungoides: A blood lymphoma that stays mostly in
replicate DNA.
the skin and causes a rash.
Ankylosing spondylitis: A form of chronic inflammation of
Plasma cell: A type of white blood cel that produces
the spine and the sacroiliac joints.
antibodies.
Antibody: A protein produced by some of the body's white
Plasmacytoma: A tumor made up of cancerous plasma
blood cel s that helps fight infection.
cel s.
Apoptosis: The programmed death of a cel ; believed to
Platelet: An element in the blood that helps with clot ing,
be governed by chemical signals a given cel receives.
which in turn helps repair damaged blood vessels.
Bone marrow: A soft spongy tissue found in most large
Protein: A group of compounds that are the main compo-
bones that produces red and white blood cel s and
nents of a cel .
platelets.
Purpura: Bleeding that occurs just below the skin that
Cell: The smal est unit of life. Mil ions of microscopic cel s
causes purple spots and patches to appear because of
comprise each body organ.
the leakage of blood into the tissues under the skin
Colitis: Inflammation of the lining of the large intestine.
Red blood cell: A blood cel that carries oxygen from the
Cytokine: A growth factor produced by T-cel s that stimu-
lungs throughout the body.
lates the growth of T cel s and B cel s.
Sarcoidosis: An inflammation of the lymph nodes and
Edematous: Swol en with an excessive accumulation of
other organs.
fluid.
Scleroderma: A connective tissue disorder characterized
Enteritis: Irritation or inflammation of the smal intestine.
by tightening of the skin of the arms, face or hands, puf y
Hematologic malignancy: A cancer of the blood or bone
hands and feet, and joint stif ness and pain that can af ect
marrow.
one part of the body or the entire body.
Immunoglobulin: An antibody.
Serum sickness: A hypersensitive reaction caused by the
administration of a foreign serum; it causes fever, swel -
Immunomodulatory agent: Drug that af ects, enhances, or
ing, skin rash, and enlargement of the lymph nodes.
suppresses the immune system.
Side effect: An ef ect caused by the treatment with a drug.
Lytic bone lesion: Dissolution or destruction of bone cel s
The term usual y refers to an unwanted ef ect, but some
leading to holes in bone.
side ef ects may be beneficial.
Metabolite: A substance that is the product of the metabo-
lism of another substance known as a parent compound
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Appointments
Systemic lupus erythematosus (SLE): A chronic, inflamma-
Date
Time
Important Notes
tory 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 bleeding 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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