Myeloma: diagnosis and management

Infections

Myeloma and the treatments for it can damage your immune system. This can make it easier for you to get infections, and harder for you to recover from them. If you have myeloma, you should be offered the yearly flu jab (also called the influenza vaccination). You may also be offered the pneumonia jab before you turn 65 (all people over 65 are already offered this).

Damage to your immune system means viruses can be worse when you get them. Depending on which myeloma treatments you are having, you may be offered medicines to help stop you getting some viruses (for example, chicken pox and shingles). Your care team may advise you to keep taking these after your myeloma treatment has finished. You may also be offered tests to see if you have certain viruses (for example, hepatitis B, hepatitis C or HIV) before you start myeloma treatment.

If you are having problems with your immune system or you keep getting infections, you may be offered treatment to help with this.

Nerve damage (peripheral neuropathy)

Some treatments for myeloma (such as bortezomib) can damage your nerves (particularly in your hands and feet), and this can cause pain and other problems. Your care team should tell you what symptoms to look out for, and encourage you to tell them if you have any of these or if they are getting worse.

If you get nerve damage, your care team may lower the dose of the medicine causing it. If you are taking bortezomib intravenously (through a drip into a vein), they may also start injecting it just underneath your skin instead.

If your nerve damage is getting worse, your care team should temporarily stop giving you the medicine that causes it.

Sometimes the symptoms of nerve damage can continue after you stop taking the medicine that caused them. If this happens and you still need medicine to treat your myeloma, your care team may offer you a medicine that is less likely to cause nerve damage.

Blood clots (thrombosis)

Blood clots form to stop you bleeding when you are injured (for example from a cut in your skin). However, some treatments for myeloma can cause your blood to clot inside your body, and this can block your veins and arteries. If the blood clot breaks away it can travel through your blood to your lungs. This is called pulmonary embolism and it can be life‑threatening.

To avoid this, you may be offered medicine to reduce the chance of your blood clotting inside your body. This will usually be aspirin or a medicine called an anticoagulant.

Fatigue

Myeloma and the treatments for it can make you feel very tired. There are lots of different causes for this, but if it is caused by anaemia (a shortage of red blood cells), you may be offered medicine to help your body produce more red blood cells.