Multiple Myeloma Treatment: How Does It Work in 2026?

Multiple myeloma is a blood cancer treated not with surgery but with a drug combination — an antibody drug, a proteasome inhibitor, an immunomodulatory drug, and a steroid — followed, when conditions allow, by autologous hematopoietic stem cell transplantation and maintenance therapy.

Key Takeaways

• Multiple myeloma treatment starts with a combination regimen that brings together an antibody drug, a proteasome inhibitor, an immunomodulatory drug, and a steroid (National Cancer Center Korea).
• If age and organ function are suitable, autologous hematopoietic stem cell transplantation follows, continuing on into maintenance therapy afterward.
• Diagnosis involves more than a bone marrow biopsy — blood and urine M-protein, free light chains, kidney function, calcium levels, and whole-body MRI or PET imaging are all added (National Cancer Center Korea, NCCN Guidelines for Patients).
• Bone-protecting medication and kidney-protective treatment are commonly carried out alongside the main therapy.
• Autologous transplant cases often plan for a total stay of 6–8 weeks, including 3–6 weeks of inpatient admission.

What Is Multiple Myeloma and How Is It Diagnosed?

• Multiple myeloma is a category of blood cancer in which plasma cells inside the bone marrow multiply abnormally. The core diagnostic step is a bone marrow biopsy, typically taken from the pelvic bone to obtain marrow fluid and tissue; cell morphology, flow cytometry, chromosome analysis, and genetic testing (such as for TP53) are then used to determine the risk group.
• On top of this, blood and urine M-protein tests, free light chain testing, kidney function, calcium levels, and whole-body MRI or PET imaging to assess bone status are added. This risk classification becomes the basis for deciding whether treatment proceeds with chemotherapy alone or advances to transplantation.
• Before treatment begins, heart, lung, liver, and kidney function are checked, along with screening for hepatitis B, hepatitis C, HIV, tuberculosis, and cytomegalovirus infection. Since blood cancer treatment substantially suppresses immunity, these tests are built into the treatment plan from the start.

What Order Does Standard Treatment Follow? (General Overview)

• Step 1, Diagnosis and risk classification — bone marrow biopsy, M-protein and free light chain testing, and chromosome/genetic testing establish the subtype and risk group.
• Step 2, Induction therapy — treatment begins with a combination of an antibody drug, a proteasome inhibitor, an immunomodulatory drug, and a steroid.
• Step 3, Deciding on transplantation — if age and organ function allow, autologous hematopoietic stem cell transplantation is considered. This method involves collecting the patient's own hematopoietic stem cells beforehand, then returning them after high-dose chemotherapy.
• Step 4, Maintenance therapy — maintenance treatment continues even after transplantation, carried out alongside bone-protecting medication and kidney-protective treatment.
• Step 5, Follow-up monitoring — M-protein, free light chains, kidney function, and calcium levels are tracked at set intervals.

What Are the Side Effects and Recovery Period?

• After high-intensity chemotherapy or autologous transplant, a period of near-zero white blood cell count can last from several days to a few weeks. During this period, fever and infection pose the greatest risk, so patients stay in a sterile ward and are managed with antibiotics and transfusions as needed.
• Difficulty eating due to mouth sores, along with nausea, diarrhea, hair loss, and severe fatigue, are common reactions. In transplantation, engraftment — the process by which the new stem cells take hold — generally takes about 2 to 4 weeks.
• Unlike allogeneic transplantation, autologous transplant does not carry the risk of graft-versus-host disease, in which a donor's immune cells attack the patient, since the patient's own cells are used. Recovery varies by individual, and the management approach may differ according to the treating medical team's judgment.

FAQ — What Records Are Needed to Receive Autologous Transplant in Korea?

It is advisable to prepare the bone marrow aspiration/biopsy report, chromosome and genetic test results (such as FISH), records of blood and urine M-protein and free light chain testing, the names, doses, number of cycles, and response for all chemotherapy drugs received, echocardiogram and lung/liver/kidney function test results, a medical certificate, and a copy of your passport. Medication history is the single most important piece of information for determining the next course of treatment.

FAQ — How Are Treatment Costs and Length of Stay Determined?

The remote review (pre-arrival review) fee is KRW 1,000,000. If you sign a treatment contract following the remote review, this amount is deducted from your medical bill. Transplant costs are broken down into categories — pre-transplant conditioning chemotherapy, the transplant procedure itself, sterile-ward admission, medication, and donor testing (if applicable) — with the final amount confirmed through the hospital's estimate. Length of stay is often planned around 4–6 weeks per chemotherapy cycle, while autologous transplant cases typically target a total of 6–8 weeks, including 3–6 weeks of inpatient admission.

Sources and Notes

• This article was written based on notes on blood cancer and hematopoietic stem cell transplantation (National Cancer Center Korea, National Cancer Center, NCCN Guidelines for Patients, medicalkorea.or.kr).
• This content is intended for general medical information purposes only, and actual diagnosis, treatment methods, and outcomes may vary depending on individual condition. Please consult with your medical team to determine the appropriate diagnosis and treatment plan for your specific case.