What is multiple myeloma?

Multiple myeloma is a cancer of plasma cells. Plasma cells are white blood cells that live in the bone marrow. Bone marrow is the soft, spongy tissue inside your bones where blood cells are made. Healthy plasma cells make antibodies, which are proteins that help fight infection. In myeloma, one plasma cell grows out of control and makes many copies of itself. These copies all make the same abnormal protein, called M-protein (monoclonal protein). The extra cells crowd out healthy blood cells. They can also weaken bones and harm the kidneys.

When should I call my care team?

Fever of 100.4 F (38 C) or higher, or shaking chills; New or sudden back pain, or new numbness, weakness, or trouble walking or controlling your bladder or bowels (this can mean pressure on the spinal cord); Confusion, extreme sleepiness, strong thirst, or severe constipation (signs of high calcium); Passing much less urine than usual, or swelling in the legs; Swelling, pain, or warmth in one leg, or sudden shortness of breath or chest pain (possible blood clot); Bleeding that will not stop, black stools, or many new bruises; After CAR-T or a bispecific antibody: fever, dizziness, trouble breathing, confusion, trouble speaking or writing, shaking, or unusual sleepiness; A painful rash with blisters on one side of the body (possible shingles); New vision changes or eye pain, especially if you take belantamab; Sudden, severe pain after a minor fall or movement (possible broken bone).

What chemotherapy plans are used for multiple myeloma?

Common treatment plans include CyBorD, DPd, DRd, DVd, ERd, IRd, Isa-Pd, KRd (CRD), PBD, RVd (VRd), Vd, VTd. Your care team picks the plan that fits your cancer and your health.

Multiple myeloma

Multiple myeloma is a blood cancer that usually cannot be cured yet, but today many people live well with it for years thanks to newer treatments.

Hi, I'm Rosa. Today we'll go through multiple myeloma together, one step at a time. I'll keep it simple, and you can pause me, go back, or skip ahead whenever you like. Just so you know, this is for learning only. It is not medical advice, so please check everything with your own doctor and care team. Okay, let's get started.

What myeloma is

Let's start with what myeloma is. Multiple myeloma is a cancer of plasma cells. Plasma cells are a kind of white blood cell. They live in the bone marrow. That is the soft, spongy inside of your bones. Healthy plasma cells make antibodies that fight infection. In myeloma, one plasma cell grows out of control. It makes many copies of itself. The extra cells crowd out healthy blood cells. They can also weaken bones and harm the kidneys. Myeloma is usually not curable today. But it is very treatable. Treatments have gotten much better.

Types and related conditions

Let's talk briefly about the types. Some people have a quiet early condition. A blood test finds a little abnormal protein. But there is no damage, and no treatment is needed. Smoldering myeloma has more abnormal cells. There is still no damage. It is watched closely. Active myeloma is causing damage, or soon will. This is the kind that needs treatment. There are rarer forms too. Light chain myeloma makes only a small piece of the protein. A plasmacytoma is a single plasma cell tumor. Your care team will tell you which one you have.

Tests you may have

Now let's talk about tests. Blood tests find and measure the abnormal protein. That level helps your team track myeloma over time. Another blood test measures small protein pieces called light chains. You may collect your urine for a whole day. Blood counts check for anemia. That means low red blood cells. Other blood tests check calcium and your kidneys. A bone marrow biopsy takes a small sample from the hip bone. You get numbing medicine first. Scans like a CT, PET scan, or MRI look for bone damage.

What the stage means

Next up, the stage. Myeloma is not staged by tumor size. First, doctors see where you are on a path. It goes from a quiet early condition, to smoldering, to active. Then they look for signs of damage. These are high calcium, kidney problems, anemia, and bone damage. Doctors also use a system with three stages. It uses blood tests and gene test results. Stages help your team plan treatment. They help everyone talk the same language. The stage does not decide your whole future. People at every stage are treated.

Lab tests and risk

Before we move to treatment, there are some things to know. Myeloma cells can have changes in their chromosomes. Chromosomes are the packages that hold your genes. A test on your bone marrow sample looks for these changes. Some changes mean myeloma may come back sooner. Doctors call this high risk. Other changes are standard risk. There are different markers, and each has a different role. Your doctor will tell you which ones you have and what they mean. You can read more in the guide. The Questions to ask page can help you prepare.

Main treatments

Now let's talk about treatment. Early quiet conditions are watched, not treated. Most smoldering myeloma is watched too. For active myeloma, treatment often starts with four medicines together. Some people then have a stem cell transplant with their own cells. Next, most people take a gentler treatment for a long time. This is called maintenance. If myeloma comes back, there are many good options. One uses your own immune cells, changed in a lab. Clinical trials are research studies that may offer new options. Ask your team about them.

Side effects and help

Let's look at side effects. Feeling very tired is common. Gentle walks and good sleep can help. Some medicines cause numbness or tingling in hands and feet. Tell your team early, so they can adjust things. Infections are more likely. Vaccines and hand washing really matter. Some medicines raise the risk of blood clots. Many people take a medicine to prevent them. Steroids can affect sleep and mood. Taking them in the morning can help you sleep. We have a whole side effects guide on this site.

Living well with myeloma

Now let's talk about living well. For most people, myeloma is managed over many years. There are often good stretches, sometimes long ones. Protect your bones and kidneys. Drink plenty of fluids unless told otherwise. Regular blood tests often spot changes early. Feelings matter too, and support groups can help. Call your care team right away for a fever. Call for new back pain or trouble walking. Call for confusion or strong thirst. If it feels very bad, call 911. Also visit our new Screening, prevention and survivorship section.

You did great today. Thank you for learning with me. Write down your questions and bring them to your next visit. You can call your care team any time, day or night. Myeloma is a long road, and you have good company on it. You are not alone.

Call your care team right away if you have

Fever of 100.4 F (38 C) or higher, or shaking chills
New or sudden back pain, or new numbness, weakness, or trouble walking or controlling your bladder or bowels (this can mean pressure on the spinal cord)
Confusion, extreme sleepiness, strong thirst, or severe constipation (signs of high calcium)
Passing much less urine than usual, or swelling in the legs
Swelling, pain, or warmth in one leg, or sudden shortness of breath or chest pain (possible blood clot)
Bleeding that will not stop, black stools, or many new bruises
After CAR-T or a bispecific antibody: fever, dizziness, trouble breathing, confusion, trouble speaking or writing, shaking, or unusual sleepiness
A painful rash with blisters on one side of the body (possible shingles)
New vision changes or eye pain, especially if you take belantamab
Sudden, severe pain after a minor fall or movement (possible broken bone)

Treatment plans (regimens)

Medicines often used

Side effects: what helps

Sources

Quick answers

What is multiple myeloma?: Multiple myeloma is a cancer of plasma cells. Plasma cells are white blood cells that live in the bone marrow. Bone marrow is the soft, spongy tissue inside your bones where blood cells are made. Healthy plasma cells make antibodies, which are proteins that help fight infection. In myeloma, one plasma cell grows out of control and makes many copies of itself. These copies all make the same abnormal protein, called M-protein (monoclonal protein). The extra cells crowd out healthy blood cells. They can also weaken bones and harm the kidneys.
When should I call my care team?: Fever of 100.4 F (38 C) or higher, or shaking chills; New or sudden back pain, or new numbness, weakness, or trouble walking or controlling your bladder or bowels (this can mean pressure on the spinal cord); Confusion, extreme sleepiness, strong thirst, or severe constipation (signs of high calcium); Passing much less urine than usual, or swelling in the legs; Swelling, pain, or warmth in one leg, or sudden shortness of breath or chest pain (possible blood clot); Bleeding that will not stop, black stools, or many new bruises; After CAR-T or a bispecific antibody: fever, dizziness, trouble breathing, confusion, trouble speaking or writing, shaking, or unusual sleepiness; A painful rash with blisters on one side of the body (possible shingles); New vision changes or eye pain, especially if you take belantamab; Sudden, severe pain after a minor fall or movement (possible broken bone).
What chemotherapy plans are used for multiple myeloma?: Common treatment plans include CyBorD, DPd, DRd, DVd, ERd, IRd, Isa-Pd, KRd (CRD), PBD, RVd (VRd), Vd, VTd. Your care team picks the plan that fits your cancer and your health.

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.