Immunotherapy is a type of treatment that affects your body’s immune system. It’s used to treat cancer. Immunotherapy medicines can work in a number of different ways. They can turn on certain immune cells so they kill cancer cells. They can mess up the signals cancer cells need to grow. And they can kill cancer cells.

Two main types of immunotherapy medicines can be used to treat multiple myeloma. 

Immunomodulating medicines (usually lenalidomide) are often part of the first treatment of multiple myeloma. In most cases, they’re used along with other medicines.

If the initial treatment stops working, your healthcare provider may give you pomalidomide or one of the monoclonal antibodies. 

Before treatment starts, your healthcare provider will talk about your treatment options with you. He or she will explain what you might expect. 

The immunomodulating medicines are taken as pills. You may take them once a day for several weeks at a time, followed by a break. 

You get monoclonal antibodies as an intravenous (IV) infusion into a vein. You’ll get it once a week to start. Then you may wait longer between treatments. You’ll likely receive these medicines in an outpatient setting. This means that you’ll get it at a hospital, clinic, or healthcare provider's office. Then you go home after your treatment. Much less often, you may need to stay in the hospital during treatment. Your treatment team will watch you for reactions during treatments. Since each of your treatments may last for a while, you may want to take along something that’s comforting to you, such as music to listen to. You may also want to bring something to keep you busy, like a book or mobile device.

Side effects of immunotherapy tend to be different from those of chemotherapy or other treatments. And they vary from person to person. But they can be serious in some people. Ask your healthcare provider for details about side effects. Tell your healthcare provider about any changes or side effects you notice. Some side effects can be prevented. And there are often things that can be done to help you feel better. In most cases, side effects start to feel better within a few weeks after treatment ends.

Some of the more common side effects from immunomodulating medicines include:

• Drowsiness and tiredness

• Constipation

• Nerve damage, which can cause burning, tingling, or decreased feeling in your hands or feet

• Blood clots in your legs or lungs

• Low white blood cell counts which can increase your risk of infection

• Low blood platelet counts, which can increase your risk of bruising and bleeding

These medicines can cause severe birth defects or even death to an unborn baby. For this reason, women need to take pregnancy tests regularly during treatment.

Monoclonal antibodies can have different side effects.

Side effects of daratumumab include:

• Serious reactions during the infusion. These might include wheezing, trouble breathing, tightness in your throat, dizziness, rash, and nausea.

• Tiredness

• Nausea

• Back pain

• Fever

• Cough

• Low blood cell counts. This increases the risks of infections and bleeding.

Side effects of elotuzumab include:

• Serious reactions during the infusion. These might include wheezing, trouble breathing, tightness in your throat, dizziness, rash, and nausea.

• Tiredness

• Loss of appetite

• Diarrhea or constipation

• Cough

• Fever

• Nerve damage. This can cause burning, tingling, or decreased sensation in your hands or feet. 

• Respiratory (lung) infections

It's important to know which medicines you're taking. Write down the names of your medicines. Ask your healthcare team how each medicine works and what side effects each might have.

Talk with your healthcare providers about what signs to look for and when to call them. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?

It may be helpful to keep a diary of your side effects. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.