Why is Dexamethasone Used in Myeloma?

Multiple myeloma patients (and their loved ones!) have a complicated relationship with corticosteroid dexamethasone. Dex can be seen as either the hero or the villain of myeloma treatment in many circumstances. The question remains: why is dexamethasone used so often in multiple myeloma treatment, and what purpose does it serve? 

Why is Dexamethasone Used In Myeloma? What Purpose Does Dexamethasone Serve in Treating Multiple Myeloma? 

It is used for several reasons:

1. Dexamethasone is a powerful corticosteroid that has anti-inflammatory and immunosuppressive properties. In multiple myeloma, the malignant plasma cells can produce inflammatory substances contributing to the disease's symptoms and complications. Dexamethasone can help reduce inflammation and alleviate some of these symptoms, such as pain and swelling.

2. Dexamethasone is frequently used in combination with other drugs, such as proteasome inhibitors (e.g., bortezomib) or immunomodulatory drugs (e.g., lenalidomide and thalidomide), to enhance the effectiveness of treatment. These combinations are often more effective in targeting multiple myeloma cells and improving the overall response to therapy. The synergy of the treatment is increased with the addition of dexamethasone. 

3. Multiple myeloma can lead to various complications, such as hypercalcemia (elevated blood calcium levels) and spinal cord compression. Dexamethasone can be used to manage these complications and alleviate associated symptoms.

As the majority of myeloma patients and their caregivers know, while dexamethasone (often referred to as dex) can be effective in treating multiple myeloma, it also has potential side effects.

These include:

• immunosuppression
• weight gain
• mood changes
• increased risk of infections

Talk to your oncologist and/or specialist if the side effects of dexamethasone become severe and interfere with the quality of your life. A dose reduction or switch of steroids may be appropriate.

Author's note: 

This article previously mentioned one of the uses of dexamethasone as having immunomodulatory effects, as presented in several articles such as this one: Dex Enhances Immunomodulatory Properties.

However, after further review and patient feedback, I've edited the article as this kind of research within the disease of myeloma itself still has not been proven and needs further evidence. That being said, the other three reasons above are excellent ways that dexamethasone can aid in multiple myeloma treatment.