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

When doctors talk about Melphalan, a powerful chemotherapy drug used to kill fast-growing cancer cells. Also known as L-PAM, it's been a backbone of cancer treatment for decades, especially for multiple myeloma. Unlike newer targeted therapies, Melphalan works by directly damaging the DNA inside cancer cells, stopping them from multiplying. It’s not a gentle drug — but for many patients, it’s one of the most effective tools they have.

Melphalan doesn’t work the same way for everyone. It’s often used in high doses before a stem cell transplant, where the goal is to wipe out as much cancer as possible before rebuilding the immune system. In lower doses, it’s taken orally as a pill for ongoing control of disease. It’s also used in some cases of ovarian cancer, a type of cancer that starts in the ovaries and often requires aggressive treatment, especially when other drugs stop working. You’ll find it paired with steroids like prednisone or used alone — the choice depends on your health, age, and how far the cancer has spread.

It’s not just about the drug itself — it’s about how your body handles it. Melphalan can lower your blood cell counts, making you more prone to infections, fatigue, or bleeding. That’s why regular blood tests are non-negotiable. Some patients get nausea or hair loss, but many report fewer side effects than with other chemo drugs. What matters most is whether it’s working — and your doctor will track that through blood markers and scans.

What you won’t find in every guide is how Melphalan fits into real-life treatment paths. Some people take it for years in low doses. Others get one high-dose round and move on. The posts below pull from real patient experiences and clinical insights — showing how Melphalan compares to newer drugs, what to do if it stops working, and how to manage the daily realities of treatment. You’ll see how it stacks up against drugs like bortezomib or lenalidomide, what side effects to watch for at home, and why some patients choose it over alternatives. This isn’t theoretical. These are the stories and facts that help people make smarter decisions when the stakes are high.