Melphalan
Say it: MEL-fuh-lan · Brand names: Alkeran, Evomela, Hepzato
Melphalan is a chemotherapy medicine that damages the DNA in cancer cells so they cannot grow.
What it is
Melphalan sticks to the DNA inside cells and links the strands together. Cancer cells cannot copy themselves and die. In high doses it also clears out the bone marrow before a stem cell transplant.
Often used for
- multiple myeloma
- high-dose treatment before a stem cell transplant for multiple myeloma
- ovarian cancer
- uveal melanoma (an eye cancer) that has spread to the liver
How you get it
Melphalan can be given through a vein (IV), or taken as a pill at home. High-dose IV melphalan is given once or over 2 days before a stem cell transplant. A special form is given directly into the liver in a procedure. Your schedule may be different.
Common side effects and what helps
- Low blood counts, which raise your risk of infection, bleeding, and tiredness. Wash your hands often.
- Nausea and vomiting. Take your anti-nausea medicine as your team tells you.
- Mouth sores, mostly with high doses. Sucking on ice chips during the infusion may help if your team says so.
- Diarrhea. Drink fluids and tell your team if it is frequent.
- Feeling tired. Rest when you need to.
- Hair loss, mostly with high doses. It usually grows back.
Call your care team right away if you have
- A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
- Bleeding or bruising that will not stop, black or bloody stools, or blood in your urine
- Trouble breathing, swelling of the face or throat, or a racing heart
- Mouth sores so painful that you cannot eat or drink
- Diarrhea that does not stop or signs of dehydration, like dizziness
Before you start, tell your team
- If you are pregnant, may become pregnant, or are breastfeeding
- If you have kidney problems
- If you have had an allergic reaction to melphalan before
- If you have had radiation or other chemotherapy
- All the medicines, vitamins, and herbal products you take
Good to know
- Melphalan can lower blood counts a lot. You will have blood tests often.
- Serious allergic reactions can happen with the IV form.
- It can affect your ability to have children.
- Rarely, it can cause a new blood cancer years later.
At home
- If you take pills, swallow them whole with water. Do not crush, cut, or chew them.
- If you miss a dose, ask your team what to do.
- Store the pills in the refrigerator in the original container, away from light, unless your pharmacist tells you otherwise.
- Caregivers should wear gloves if they touch the pills and wash hands after.
Questions to ask
- Will I get this as a pill, an IV, or before a transplant?
- How long will my blood counts stay low?
- How can I prevent mouth sores?
- Will this affect my ability to have children?
Part of these treatment plans
Side effect guides
- Fatigue (tiredness)
- Nausea and vomiting
- Diarrhea
- Mouth sores
- Hair loss
- Low white blood cells and infection risk
- Low platelets and bleeding
Sources
Quick answers
- What is Melphalan?
- Melphalan is a chemotherapy medicine that damages the DNA in cancer cells so they cannot grow. Brand names: Alkeran, Evomela, Hepzato.
- What is Melphalan used for?
- multiple myeloma; high-dose treatment before a stem cell transplant for multiple myeloma; ovarian cancer; uveal melanoma (an eye cancer) that has spread to the liver.
- How is Melphalan given?
- Melphalan can be given through a vein (IV), or taken as a pill at home. High-dose IV melphalan is given once or over 2 days before a stem cell transplant. A special form is given directly into the liver in a procedure. Your schedule may be different.
- What are the common side effects of Melphalan?
- Low blood counts, which raise your risk of infection, bleeding, and tiredness. Nausea and vomiting. Mouth sores, mostly with high doses. Diarrhea. Feeling tired. Hair loss, mostly with high doses.
- When should I call my care team while taking Melphalan?
- A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills; Bleeding or bruising that will not stop, black or bloody stools, or blood in your urine; Trouble breathing, swelling of the face or throat, or a racing heart; Mouth sores so painful that you cannot eat or drink; Diarrhea that does not stop or signs of dehydration, like dizziness.
- Which chemotherapy plans include Melphalan?
- BEAM.
Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.