Melphalan: What It Is, How It's Used, and What You Need to Know

When doctors talk about Melphalan, a powerful chemotherapy drug classified as an alkylating agent used to kill fast-growing cancer cells. Also known as L-PAM, it's been a backbone treatment for decades, especially in cases where other options have failed. Melphalan doesn't just target cancer—it changes how cells divide, stopping them from multiplying. It's not a new drug, but it's still one of the most trusted tools in oncology, especially for multiple myeloma, a cancer of plasma cells in the bone marrow.

What makes Melphalan different from newer targeted therapies is how it works. Instead of going after one specific protein or gene, it attacks DNA directly. That’s why it’s often used in high-dose regimens before a stem cell transplant. The idea is simple: wipe out as many cancer cells as possible, then rebuild the immune system with healthy stem cells. It’s harsh, but for many patients, it’s the best shot at long-term control. Melphalan is also used in ovarian cancer, a type of cancer that starts in the ovaries and often spreads silently, and sometimes in rare lymphomas. It comes as a pill or an IV, and dosing depends on weight, kidney function, and whether it’s part of a transplant plan.

Side effects are common because Melphalan doesn’t just hit cancer cells—it hits fast-growing healthy cells too. That means nausea, low blood counts, hair loss, and fatigue are typical. Some people get mouth sores or feel more prone to infections. But these aren’t random side effects—they’re signs the drug is working. Doctors monitor blood counts closely and adjust treatment to balance effectiveness and safety. If you’re on Melphalan, you’ll need regular blood tests, hydration, and sometimes growth factors to help your body recover.

There’s no magic fix with Melphalan. It’s not for everyone. But for those with multiple myeloma who’ve tried other treatments, it’s often the next step that makes a real difference. You’ll find posts here that break down how it compares to newer drugs, what real patients report about side effects, how it fits into transplant protocols, and even how cost and access vary across regions. Whether you’re a patient, caregiver, or just trying to understand the science behind cancer treatment, the articles below give you the practical details—not just the textbook definitions.