Myeloma Regimens

The information contained in these regimens is a statement of consensus of NCCP and ISMO or IHS professionals regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these documents is expected to use independent medical judgement in the context of individual clinical circumstances to determine any patient's care or treatment. The treatment regimen to be used should take into account factors such as histology, molecular pathology, age, performance status, co-morbidities and the patient’s preference. Each treatment regimen has advantages and disadvantages, and there may be more than one good option.  In addition, treatment choices can change over time as more evidence becomes available. Use of these documents is the responsibility of the prescribing clinician and is subject to the HSE.ie terms of use

Please email any comments or feedback on these regimens to oncologydrugs@cancercontrol.ie

Myeloma Chemotherapy Regimens

Regimen Name Indication

Bortezomib and Dexamethasone Therapy

Regimen

00270a

Treatment of adult patients with progressive multiple myeloma who have received at least one prior therapy.

Bortezomib Maintenance Therapy- 14 day

 Regimen

00435a

Maintenance treatment for patients with high risk  multiple myeloma

Bortezomib, Lenalidomide and Dexamethasone (RVD) Therapy-21 day*

Regimen

00416a

Treatment of newly diagnosed myeloma in adult patients with high risk features.

00416b

Treatment of relapsed or refractory myeloma that has received prior therapy in adult patients with high risk features.

Bortezomib, Melphalan and Prednisolone Therapy

Regimen

00275a

Treatment of adult patients with previously untreated multiple myeloma who are not eligible for high-dose chemotherapy with haematopoietic stem cell transplantation.

Bortezomib, Thalidomide and Dexamethasone (VTD) Induction Therapy

Regimen

00274a

Bortezomib, thalidomide and dexamethasone for induction treatment of adult patients with previously untreated multiple myeloma who are eligible for high-dose chemotherapy with haematopoietic stem cell transplantation.

Carfilzomib, Lenalidomide and Dexamethasone (KRd) Therapy -  28 day

 Regimen

00405a

Carfilzomib,  lenalidomide and dexamethasone therapy is indicated  for the treatment of adult patients with multiple myeloma who have received at least one prior therapy

CyBorD/ Cylophosphamide, Bortezomib, and Dexamethasone-21 day Therapy

Regimen

00273a

Treatment of newly diagnosed symptomatic multiple myeloma*

00273b

Treatment of relapsed/refractory multiple myeloma*

Daratumumab Monotherapy

Regimen

00426a

As monotherapy for the treatment of adult patients with relapsed and refractory multiple myeloma whose prior therapy included a proteasome inhibitor and an immunomodulatory agent and who have demonstrated disease progression on the last therapy.

High Dose Melphalan Conditioning Therapy for Autologous Stem Cell Transplant

Regimen

00454a 

Conditioning Therapy in patients with Multiple Myeloma prior to autologous stem cell transplant 

00454b

Conditioning Therapy in patients with other plasma cell dyscrasia such as AL amyloidosis

Ixazomib, Lenalidomide and Dexamethasone Therapy -  28 day

 Regimen

00516a

Ixazomib in combination with lenalidomide and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy

Lenalidomide 25mg and Dexamethasone Therapy-28 day

Regimen

00218a

Treatment of adult patients with previously untreated multiple myeloma who are not eligible for transplant.

00218b

Treatment of multiple myeloma in adult patients who have received at least one prior therapy.

Modified CyBord/ Bortezomib/ Cyclophosphamide and Dexamethasone – weekly therapy

 Regimen

00299a

Treatment of newly diagnosed symptomatic multiple myeloma.

00299b

Treatment of relapsed/refractory multiple myeloma.

Plerixafor and G-CSF Therapy

Regimen

00536a

Is indicated in combination with granulocyte-colony stimulating factor (G-CSF) to enhance mobilisation of haematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in adult patients with lymphoma and multiple myeloma whose cells mobilise poorly 

Pomalidomide and Dexamethasone

Regimen

00245a

Treatment in combination with dexamethasone of adult patients with relapsed and refractory multiple myeloma who have received at least two prior treatment regimens, including both lenalidomide and bortezomib, and have demonstrated disease progression on the last therapy.