Multiple myeloma affects the immune system and can lead to bone pain, fatigue, and cognitive changes.

While it isn’t curable, it is highly treatable with modern, intensive therapies.

“Multiple myeloma is a cancer where plasma cells grow out of proportion to the other cells,” explained Dr. Nina Shah, a hematologist at UCSF. “Because of that, they can cause different symptoms, and that’s how we diagnose it.”

Risk level in multiple myeloma is determined by specific genetic changes:

• Standard‑risk disease often involves extra copies of certain chromosomes.
• High‑risk disease is typically associated with the loss of part of chromosome 17.

WATCH: Standard Risk vs. High Risk Multiple Myeloma

These genetic differences influence how aggressive the cancer is. While induction therapy and stem cell transplant approaches are similar across risk groups, maintenance therapy is tailored based on a patient’s risk profile.

Kelley says he’s preparing for six months of treatment but hopes it won’t completely take over his life.

“I want to keep working because I need to be happy and doing what I love to do. I’m hopeful,” he said.

Newer Treatments for Multiple Myeloma Patients

Beginning in Fall 2026, people living with multiple myeloma will see two major advances that not only expand treatment options but, for many, dramatically reduce the time spent receiving therapy.

The FDA has approved a new subcutaneous formulation of the targeted drug isatuximab (Sarclisa), allowing it to be given as a quick injection under the skin rather than through an hours‑long IV infusion.

Isatuximab, a monoclonal antibody long used in myeloma care, targets the CD38 protein on myeloma cells. The new under‑the‑skin version delivers the same therapy with far greater convenience.

“This provides another excellent line of therapy for the treatment of multiple myeloma for patients who have progressed on first‑line,” says Dr. Trailokya Pandit, hematologist and medical oncologist at Piedmont Healthcare in Atlanta.

The FDA has also granted accelerated approval to iberdomide (ZENBEXUS)—a next‑generation immune‑modulating therapy—for use with daratumumab and hyaluronidase‑fihj plus dexamethasone (ZDd).

This regimen is intended for adults who have already received at least one prior treatment, including a proteasome inhibitor and an immunomodulatory drug such as thalidomide, lenalidomide, or pomalidomide.

Iberdomide belongs to a new class of cereblon‑modulating protein degraders known as CELMoDs, designed to overcome resistance seen with older IMiDs. These oral agents work by targeting the cereblon E3 ligase complex—“essentially the cell’s protein‑disposal system,” explains Dr. Paul Richardson of Dana‑Farber Cancer Institute.

By shutting down this central switchboard, CELMoDs trigger the destruction of key survival proteins like Ikaros and Aiolos, killing myeloma cells and rallying the immune system to clear what remains.

“This is such an important advance,” Dr. Richardson adds. “An oral therapy can be given in community practices in the Midwest, in suburban settings, and in urban settings. This is very, very important. I think FDA will be looking to move this very quickly to full approval, and I certainly hope so.”

Understanding Multiple Myeloma

Multiple myeloma is a rare and incurable type of blood cancer. When you have this cancer, white blood cells called plasma cells (the cells that make antibodies to fight infections) in your bone marrow grow out of proportion to healthy cells.

Those abnormal cells leave less room for your body’s healthy blood cells to fight infections. They can also spread to other parts of your body and cause problems with organs like your kidneys.

“In general, having blood cancer means that your bone marrow is not functioning correctly,” Dr. Shah explained to SurvivorNet.

Known risk factors for multiple myeloma include your age, family history of cancer, and whether you have monoclonal gammopathy of undetermined significance (MGUS). MGUS is a condition that occurs when you have too much monoclonal protein in your blood and bone marrow.

Most people diagnosed are in their 60s. However, people younger than 60 can also get this type of cancer, and if you have a close relative with multiple myeloma, that can increase your risk.

WATCH: Recognizing multiple myeloma symptoms.

Multiple myeloma can cause symptoms such as weakness, dizziness, bone pain, and confusion, among other symptoms.

Doctors use blood and urine tests and imaging tests such as X-rays or MRIs to help diagnose multiple myeloma and to guide treatment options. Ultimately, a bone marrow biopsy will confirm the diagnosis.

Treatment Options for Multiple Myeloma

Treatment for multiple myeloma depends on your risk level. Some patients are considered standard risk, while others are high-risk. Your risk depends on irregularities in the chromosomes of your cancer cells.

The standard treatment approach for multiple myeloma goes from the induction phase, the stem-cell transplant phase, and then the maintenance phase.

• Induction Phase: This phase is the same regardless of risk. It consists of triplet drug therapy, which includes an immunomodulatory drug (Revlimid or Pomalyst), a proteasome inhibitor (Kyprolis, Velcade, or Ninlaro), and a steroid (dexamethasone or prednisone).
• Stem-Cell Transplant Phase: This phase is the same regardless of risk. It consists of chemotherapy coupled with a stem-cell transplant.
• Maintenance Phase: This phase will differ based on the risk profile.

Maintenance treatment is essential because it keeps the cancer at bay. Since multiple myeloma patients face the risk of relapse even if the cancer is put into remission, maintenance treatment helps keep the cancer in remission for longer periods.

This drug activates immune cells that kill bacteria, viruses, and cancers. It also reduces vital blood flow to cancerous tumors, helping kill them. However, some patients don’t tolerate lenalidomide well because of some of its potential side effects, including nausea, vomiting, swelling of the limbs and skin, and liver problems.

When Multiple Myeloma Relapses, You Still Have Options

When your multiple myeloma comes back within about a year, your disease is generally classified as ‘high risk.’

When multiple myeloma returns after treatment, “It usually means that there were residual cells, even in very small numbers. They were either resistant to the treatment from the start, or they acquired resistance as the treatment was growing,” Dr. Anderson explains to SurvivorNet.

In other words, not every myeloma cell in your body is precisely the same. Some start with a set of mutations that can give them resistance to treatments and make them more likely to relapse, whereas others develop mutations as a result of treatment.

WATCH: What Is the Standard of Care for the First Relapse?

The Signs of a Multiple Myeloma Relapse

• Increased levels of monoclonal antibodies: myeloma cells are cancerous plasma cells in the bone marrow that overgrow and produce abnormal proteins. These abnormal proteins are released in the blood and can be detected by physicians. When the levels of these increase substantially, that can be a sign that multiple myeloma has relapsed.
• Increase in plasma cells in the bone marrow: Oncologists can use magnetic imaging, like MRI or PET scans, to see if there is a greater than normal level of plasma cells in the bone marrow, which is typical of overly dividing myeloma cells.
• Bone fractures and lesions: Myeloma cells activate the cells that break down bones and deactivate the cells that build up bones, which can result in fractures or small holes in bones. Oncologists can use X-rays or CT scans to detect bone damage indicative of relapse.

When or if multiple myeloma returns, remember that many treatment options exist. Oncologists may turn to therapies approved only for clinical trials, namely CAR T-cell therapy

Treatment Option for When Multiple Myeloma Returns

In March 2026, the FDA approved the combination of teclistamab and daratumumab — often referred to as Tec Dara — for certain patients with multiple myeloma.

Teclistamab is part of a newer class of treatments called bispecific antibodies, which help the immune system better recognize and attack myeloma cells. By directing immune cells toward the cancer, these therapies can lower disease levels and keep the cancer controlled for longer, giving patients more time before needing another treatment.

WATCH: An Option When Multiple Myeloma Returns

Dr. Sagar Lonial, chief medical officer at Emory Winship Cancer Institute, tells SurvivorNet that the two drugs appear to work especially well together.

“It’s thought that the combination of teclistamab and daratumumab has synergy. Daratumumab eliminates some of the cells that may limit the activity of the bispecific antibody, releasing more effective T cell activity,” he explains.

“It’s immune therapy on steroids, if you will.”

For patients, the combination may offer:

• Longer periods of disease control
• Deeper treatment responses
• Another option if the cancer returns after earlier therapy

The FDA granted approval through its National Priority Voucher program, which accelerates review for promising treatments targeting serious illnesses.

As with most cancer therapies, side effects are possible. Tec Dara can cause cytokine release syndrome (CRS), an immune reaction that may lead to symptoms such as fever or low blood pressure. Signs of CRS can include:

• Fever
• Low oxygen levels
• Chills
• Low blood pressure
• Increased heart rate
• Headache
• Elevated liver enzymes

Questions for Your Doctor

If you are facing a multiple myeloma diagnosis, you may be interested in the treatment Tom Brokaw has had success with. Here are some questions to help you begin the conversation with your doctor:

• What stage is my multiple myeloma?
• What are my treatment options?
• Am I a good candidate for Revlimid?
• What are the possible side effects of your recommended treatment?
• Who will be part of my healthcare team, and what does each member do?
• Can you refer me to a social worker or psychologist who can help me cope with my diagnosis?

Learn more about SurvivorNet's rigorous medical review process.

---