Overview and Background

Smoldering Multiple Myeloma

Overview of Autologous Stem Cell Transplantation

Initial Treatment - When Stem Cell Transplants Are Planned

Measuring Response to Treatment

Shared Decision-Making in Multiple Myeloma Care

Design and created by Guideline Central in participation with the American Society of Clinical Oncology and Cancer Care Ontario.

Multiple Myeloma

Patient Summary

American Society of Clinical Oncology

Cancer Care Ontario

Publication Date: June 29, 2026

This patient summary provides guidance on the management of multiple myeloma.
Multiple myeloma is a type of blood cancer that starts in the bone marrow (the soft, spongy center inside bones where blood cells are made).
In multiple myeloma, a kind of white blood cell called a plasma cell starts growing out of control. This can cause issues for your bones, kidneys, and blood cells.
Many people do not notice symptoms early in the disease. When symptoms occur, they may include:
- Bone pain (often in the back, hips, chest, or legs)
- Feeling very tired or weak
- Getting infections more often
- Unplanned weight loss
- Constipation
The treatment for multiple myeloma depends on a number of things, including:
- The stage of the disease
- The presence or absence of high-risk features
- The possibility of stem cell transplant
- Whether the disease has returned or has not responded to treatment
While there is no cure for multiple myeloma, there are many treatment options that can help to effectively manage the disease. You and your doctor will determine a treatment plan designed for you and the specifics of diagnosis.
Additional treatment terms to know
- Targeted therapy
  - Drugs that specifically target the cancer's unique genetic features or pathways while sparing as much normal tissue as possible.
- Immunotherapy
  - A treatment that uses your body’s own immune system to find and attack cancer cells. It uses special medicines to boost the immune system or help it work better to fight cancer.
- Corticosteroids
  - Corticosteroids (also called “steroids”) are powerful anti-inflammatory drugs that can kill myeloma cells and boost the effect of other myeloma therapies. They also have properties that reduce drug reactions, nausea and pain.
- Chemotherapy
  - A treatment with anti-cancer drugs that may be injected under the skin or into a vein, or taken by mouth. These drugs travel through the bloodstream and reach most parts of the body. They mainly affect the DNA of cancer cells.

Source Citation

Banerjee R, Cheung MC, Derman B, et al. Treatment of Multiple Myeloma: ASCO Ontario Health (Cancer Care Ontario) Living Guideline, Version 2026.1.1. J Clin Oncol. 2026 May 20. doi: 10.1200/JCO-26-01139

Multiple Myeloma

Patient Summary

Overview and Background

Smoldering Multiple Myeloma

Overview of Autologous Stem Cell Transplantation

Initial Treatment - When Stem Cell Transplants Are Planned

Initial (Induction) Therapy

Stem Cell Collection

Conditioning Therapy and Transplantation

Maintenance Therapy

Measuring Response to Treatment

Initial Treatment- When Stem Cell Transplants Are Not Planned

Initial Therapy

Goals and Measuring Response to Treatment

Relapsed / Refractory Multiple Myeloma

Combination Therapies or Immunotherapies for Relapsed/Refractory Multiple Myeloma

Transplantation

Supportive Care

Shared Decision-Making in Multiple Myeloma Care

Working Together on Your Treatment Plan

Understanding Your Diagnosis

Talking About Treatment Options

Understanding the Treatment Journey

Discussing Goals of Care

Considering Side Effects, Access, and Convenience

Source Citation