Melphalan: what it does and how to stay safe on it
Melphalan is a chemotherapy drug used mainly for multiple myeloma and some ovarian cancers, and as part of high‑dose conditioning before stem cell transplant. It works by damaging cancer cell DNA so those cells stop dividing. If your doctor suggested melphalan, you probably want to know what to expect and how to protect yourself while on treatment.
How melphalan is given
Melphalan comes as an oral tablet and as an intravenous (IV) infusion. Doctors choose the form based on the condition being treated. Low‑dose oral schedules may be daily or on specific days of a cycle, while high‑dose IV melphalan is often given once before transplant. Doses and timing vary a lot, so follow your oncology team’s instructions exactly.
Before each cycle you’ll usually get blood tests to check white cells, platelets, and kidney and liver function. Those results guide dose changes or delays. Don’t change the dose on your own, even if you feel fine.
Side effects, fertility, and safety tips
The most common problem with melphalan is bone marrow suppression. That means lower white blood cells, red cells, and platelets — which raises infection, bleeding, and fatigue risks. You may get growth‑factor shots, transfusions, or antibiotics if counts drop too low.
Other side effects include nausea, vomiting, mouth sores (mucositis), hair thinning, and diarrhea. Your team can give medicines to prevent or treat these. Staying hydrated and using gentle mouth care helps reduce mucositis.
Melphalan can cause permanent infertility in men and women. If having biological children matters to you, talk about sperm banking or egg/embryo freezing before treatment starts. Ask about timing — fertility steps need to happen before chemo begins.
This drug can also raise the long‑term risk of secondary blood cancers. Your doctor should review this risk in the context of your disease and other treatment options.
Avoid live vaccines while on melphalan and until your immune system recovers. Take extra care with infections: stay away from sick people, wash hands often, and call your oncology clinic for fever or signs of infection.
Tell your care team about all medicines, supplements, and herbs you take. Some drugs add extra bone marrow suppression or change how melphalan behaves in the body.
Practical checklist: get baseline blood tests, discuss fertility preservation, arrange anti‑nausea meds, learn infection signs, and keep a direct line to your clinic for any fever, bleeding, or sudden shortness of breath. Small steps before and during treatment make a big difference in safety and comfort.
If you want deeper details about dosing schedules, fertility options, or what to do for specific side effects, ask your oncologist or a pharmacist. They can tailor answers to your exact situation and help you plan next steps.
