Intensive first-line treatment

The standard approach for the first-line treatment of younger and/or fitter myeloma patients is intensive treatment involving a much higher dose of chemotherapy followed by SCT (HDT-SCT). This approach is considered to provide the best chance of achieving a deep and durable response and improved OS.

However, HDT-SCT is also associated with substantial side effects and not all eligible patients wish to proceed, preferring instead to undergo non-intensive treatment. In these situations, nurses should support such decisions and advocate on their patients’ behalf.

The following sections describe the various initial intensive first-line treatments prior to HDT-SCT, otherwise known as induction treatment. HDT-SCT itself is explained in greater detail in Module 6.