Strong analgesics and radiation therapy directed at the affected bones can help relieve bone pain, which can be severe. People who have multiple myeloma, especially with Bence Jones proteins in the urine, need to drink plenty of fluids to dilute the urine and help prevent dehydration, which can make kidney failure more likely. However, running and heavy lifting should be avoided because the bones are weakened. High calcium levels in the blood can be treated with prednisone and intravenous fluids and sometimes with diphosphonates, drugs that lower calcium levels. People who have high levels of uric acid in the blood may benefit from allopurinol.
Chemotherapy slows the progression of multiple myeloma by killing the abnormal plasma cells.
The drugs most frequently used are melphalan and cyclophosphamide. Because chemotherapy kills normal cells as well as abnormal ones, the blood cells are monitored and the dose is adjusted if the number of normal white blood cells and platelets decreases too much. Corticosteroids such as prednisone or dexamethasone are also given as part of the chemotherapy. For those who have a good response to chemotherapy, the drug interferon may enable the response to last longer. High-dose chemotherapy combined with radiation therapy is still experimental.