Myeloma develops and grows in the bone marrow. The disease can suppress the bone marrow’s ability to make new blood cells (myelosuppression, or bone marrow suppression). Many of the drugs used to treat multiple myeloma can cause myelosuppression as well.

What Is Myelosuppression?

Myelosuppression, also known as bone marrow suppression, is a decrease in bone marrow activity that results in reduced production of blood cells. Some blood cell disorders include:

  • fewer red blood cells (anemia)
  • fewer white blood cells (neutropenia)
  • fewer platelets (thrombocytopenia)

Managing Treatment Side Effects:

The risk of myelosuppression varies with each medication. Managing side effects can:

  • reduce your discomfort
  • prevent serious complications
  • allow you to receive the best treatment for your disease

To manage symptoms of myelosuppression, your healthcare provider may change your medication dose or schedule. Do not stop or adjust medications without discussing it with your healthcare provider.

Learn more about anemia, low red blood cell or low hemoglobin count.


Neutrophils are a type of white blood cell. They make up about 60% of the immune system’s cells. Neutrophils provide defense against fungal and bacterial illnesses. They are the first cells to arrive at the site of an infection.

Neutropenia is a decrease in the number of these neutrophils. Thus, the greatest concern with neutropenia is infection.

Symptoms of Infection

If you experience symptoms of infection, contact your healthcare provider immediately. Infection in a multiple myeloma patient can be lethal. Do not ignore any of the following possible symptoms:

  • fever of 100.5°F (38°C) or higher
  • shaking chills
  • dizziness
  • fainting
  • redness at a wound site
  • difficulty breathing
  • cough
  • sinus congestion
  • sore throat
  • mouth sores

Your physician will check your blood counts. She or he may prescribe antibiotics to prevent infections as well as growth factors to stimulate white blood cell growth.

Some Tips on How to Reduce Your Risk of Infection

While these tips may be obvious, here is a quick reminder:

  • Wash your hands often.
  • Avoid crowds.
  • Take antibiotics as prescribed by your healthcare provider.

Thrombocytes & Thrombocytopenia

Thrombocytes are platelets, or the blood cells that help to clot the blood after an injury. Thrombocytopenia is a decrease in these platelets. It is often a side effect of treatment with proteasome inhibitors such as Velcade® (bortezomib), Kyprolis® (carfilzomib), and Ninlaro® (ixazomib). If you experience signs of thrombocytopenia, contact your healthcare provider immediately.

Symptoms of Thrombocytopenia

Symptoms include:

  • bruising
  • pink urine
  • nosebleeds
  • small red or purple spots on the body (petechiae)
  • bleeding that does not stop with pressure

Your physician will monitor blood counts. She or he may make changes in the choice, dosing, or scheduling of your medications or other treatments. If necessary, your doctor may prescribe a platelet transfusion. 

How to Reduce Your Risk of Bruising or Bleeding

  • Do not take aspirin, ibuprofen, or naproxen. 
  • Avoid activities that can cause bruising or bleeding.


The International Myeloma Foundation medical and editorial content team

Comprised of leading medical researchers, hematologists, oncologists, oncology-certified nurses, medical editors, and medical journalists, our team has extensive knowledge of the multiple myeloma treatment and care landscape. Additionally, Dr. Brian G.M. Durie reviews and approves all medical content on this website. 

Last Medical Content Review: August 10, 2021

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