CyBorD

Say it: SY-bord

Cyclophosphamide, bortezomib and dexamethasone

CyBorD is a three medicine plan for multiple myeloma and related diseases, using cyclophosphamide, bortezomib shots and dexamethasone.

Also called: VCd, VCD, CyBorD, CYBORD, Cy-Bor-D, Dara-CyBorD, bortezomib cyclophosphamide dexamethasone

What it is

Bortezomib blocks the protein recycling system inside myeloma cells. Cyclophosphamide is a chemotherapy that damages their DNA. Dexamethasone kills myeloma cells directly. It is often used when the kidneys are working poorly, because these medicines can usually still be given safely.

Often used for

• newly diagnosed multiple myeloma, especially when kidney problems are present
• AL amyloidosis, often with daratumumab added
• multiple myeloma that has come back

Dara-CyBorD

Daratumumab is added for AL amyloidosis. This is now a standard first treatment for that disease.

Weekly vs twice weekly bortezomib

Bortezomib may be given once a week in 28 day cycles or twice a week in 21 day cycles. Weekly dosing usually causes less nerve damage.

The medicines in this plan

Cyclophosphamide

Chemotherapy taken as pills once a week, or given through a vein.

Bortezomib

Proteasome inhibitor given as a quick shot under the skin, usually once a week.

Dexamethasone

Steroid taken by mouth, usually once a week.

How you get it

Bortezomib shots are given in the clinic. Cyclophosphamide and dexamethasone are often pills taken at home. Cycles are usually 28 days with weekly visits, often for about 4 to 6 cycles before a stem cell transplant or other next step. Your schedule may be different.

A typical cycle

Days 1, 8, 15 and 22

Clinic visit for a bortezomib shot. Take cyclophosphamide and dexamethasone pills on the same day.

Between visits

Rest at home. Blood counts may dip in the middle of the cycle.

Every cycle

Blood tests to check counts, kidneys and myeloma proteins.

Common side effects and what helps

• Tingling, numbness or burning in the hands and feet from bortezomib. Tell your team early so they can adjust treatment.
• Low blood counts. Wash your hands often and stay away from people who are sick.
• Tiredness. Rest and short walks can help.
• Nausea. Take anti-nausea medicine as directed.
• Diarrhea or constipation. Drink fluids and ask about medicines that help.
• Redness or a small bump where the shot was given. It usually fades in a few days.
• Dizziness when standing up. Stand up slowly.
• Trouble sleeping, mood changes and high blood sugar on dexamethasone days. Take it in the morning with food.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Burning, painful or bloody urine
• Fainting or feeling like you will pass out
• Trouble breathing, chest pain, or a fast or pounding heartbeat
• Numbness or weakness that makes it hard to walk, button clothes or hold things
• Throwing up or diarrhea that keeps you from drinking or keeping down your medicines

Good to know

• You will take an antiviral medicine (such as acyclovir) to prevent shingles while on bortezomib.
• Cyclophosphamide can irritate the bladder. Drink plenty of fluids and empty your bladder often.
• Your team checks your nerves at each visit and may lower the bortezomib dose if numbness gets worse.
• If you have AL amyloidosis, your team will also watch your heart and kidneys closely.

At home

• Take cyclophosphamide pills in the morning with plenty of water.
• Take your antiviral medicine every day as prescribed.
• Drink plenty of fluids unless told to limit them.
• Wear shoes that fit well and check your feet if they feel numb.
• Wash your hands often and stay away from people who are sick.

Questions to ask

• How many cycles will I get?
• Will I take cyclophosphamide as pills or through a vein?
• Am I a candidate for a stem cell transplant?
• What should I do if my hands or feet start to tingle?
• How will we know if the treatment is working?

Multiple myeloma

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.