Common Induction Therapy Side Effects
- Induction therapy is a combination of three or four drugs that you get at the start of multiple myeloma treatment.
- The most common side effect is fatigue, which can be severe.
- Low blood cell counts can cause anemia, easy bruising or bleeding and an increased risk for infections.
- Numbness and tingling of the hands and feet is a side effect of the drug Velcade.
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Read MoreFatigue
"The most common side effect associated with all of the therapies for myeloma is fatigue," Dr. Krisstina Gowin, assistant professor of medicine at the University of Arizona Cancer Center, tells SurvivorNet. "It is one of the most difficult side effects, because there’s not a quick fix."Both multiple myeloma and the medications you take to treat it cause fatigue. This isn't normal fatigue. It's much more severe, and it lasts longer.
To minimize the tiredness, try to:
- Eat more energy-boosting foods, like fruits, vegetables, lean protein, and whole grains.
- Be active every day, even if you just take a walk.
- Stick to a regular sleep schedule.
Low Blood Counts
Multiple myeloma medications attack the cancer cells in your bone marrow, where new blood cells form. It can also damage some healthy blood cells. Which side effects you have depend on the type of blood cell affected.
- Too few of the red blood cells that carry oxygen to your body causes anemia. Symptoms include fatigue and shortness of breath.
- If your white blood cell count is low, your body will be less able to fight off infections. Fever is one sign that you have an infection.
- A drop in platelets can lead to easier bruising and trouble stopping the bleeding if you injure yourself.
Your doctor will monitor your blood cell counts throughout your treatment. If they dip too low, you may need to take breaks from the chemo. Or you might get injections to stimulate your body's production of red and/or white blood cells.
Numbness and Tingling
One medication, bortezomib (Velcade), causes numbness and tingling of the hands and feet. Your doctor will call this side effect peripheral neuropathy.
Be aware of this side effect and tell your treatment team after every injection if you have it. "If there is worsening neuropathy, your doctor needs to know," Dr. Gowin says. "The bad thing about neuropathy is that sometimes it is not reversible. So you want to catch that early."
RELATED: Finding the Right Drug Combination for Multiple Myeloma Induction Therapy
Lowering your dose of Velcade or skipping a dose can stop the numbness and tingling. You might also try drinking extra fluids around the time of your injection. Dr. Gowin finds that treatments like acupuncture and topical cannabinoids sometimes help with this symptom.
"But I think prevention is the best strategy, and communication with the care team," she adds.
Trouble with Transfusions
Daratumumab (Darzalex) has a unique side effect. It's an antibody a type of blood protein that helps our bodies recognize foreign substances in our blood. Darzalex can interfere with the tests a blood bank uses to match you with donor blood if you ever need a transfusion.
Dr. Gowin suggests getting a type and screen pre-transfusion test before you start Darzalex treatment. Keep the results in your wallet in case you need them in the future.
Also tell your doctors and your loved ones that you took Darzalex. The drug might make it harder to cross-match you with a donor's blood to determine compatibility. This could complicate getting a transfusion.
This isn't the full list of induction therapy side effects. Before you start treatment, go over all the possible side effects with your treatment team. Find out what to do if you have any problems, and when you should call the office.
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