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

When doctors talk about Melphalan, a chemotherapy drug that damages cancer cells by breaking their DNA. Also known as L-PAM, it's been used for decades to treat cancers that don't respond to other treatments. Unlike some newer drugs that target specific proteins, Melphalan works more like a blunt instrument—it goes after fast-growing cells, both cancerous and healthy. That’s why it’s powerful but also tough on the body.

Melphalan is most commonly used for multiple myeloma, a type of blood cancer that affects plasma cells in the bone marrow. It’s often part of the first-line treatment, especially before a stem cell transplant. It’s also used for ovarian cancer, particularly when other drugs stop working. You’ll find it in both pill form and as an IV injection, depending on the treatment plan. Some patients get it as a high-dose therapy right before a transplant, while others take lower doses over time to keep the cancer in check.

It’s not a gentle drug. Common side effects include low blood counts, nausea, hair loss, and fatigue. Because it wipes out healthy white blood cells too, patients need regular blood tests to watch for infections. Some people develop long-term risks like secondary cancers or fertility issues, which is why doctors don’t use it lightly. It’s also not something you’d take on your own—this is strictly hospital or clinic-administered therapy.

If you’re looking at Melphalan, you’re probably weighing it against other chemo drugs like alkylating agents such as cyclophosphamide or bendamustine. Each has different side effect profiles and effectiveness depending on the cancer type and stage. Some newer targeted therapies and immunotherapies are replacing Melphalan in certain cases, but it still holds its ground because it’s reliable, well-studied, and affordable.

The posts below cover real-world experiences and comparisons you won’t find in brochures. You’ll see how Melphalan stacks up against other cancer treatments, what patients actually go through, how side effects are managed, and what alternatives exist when Melphalan stops working. These aren’t just summaries—they’re practical guides from people who’ve been through it, with details on dosing, timing, and how to cope with the daily realities of treatment.