Observation for smoldering or asymptomatic disease
Supportive care for all patients, including pain control, hydration, and treatment of anemia, hypercalcemia, and infections
Proteasome inhibitors such as bortezomib, carfilzomib, or ixazomib
Immunomodulatory drugs such as lenalidomide, thalidomide, or pomalidomide
Corticosteroids such as dexamethasone
Anti-CD38 monoclonal antibodies such as daratumumab or isatuximab
Alkylating agents such as cyclophosphamide or melphalan
Autologous stem cell transplant in eligible patients
Maintenance therapy after initial treatment, often with lenalidomide
Radiation therapy for localized bone pain or plasmacytoma
Bisphosphonates or denosumab for bone disease
Plasmapheresis for hyperviscosity or selected cases of cast nephropathy
Treatment of renal impairment with aggressive hydration and avoidance of nephrotoxins
Antiviral prophylaxis when using proteasome inhibitors
Thrombosis prophylaxis when using immunomodulatory drugs
Enrollment in clinical trials when available
Palliative care for advanced or refractory disease