Practical management of disease-related manifestations and drug toxicities in patients with multiple myeloma

Catarina Geraldes, Adriana Roque, Ana Bela Sarmento-Ribeiro, Manuel Neves, Alina Ionita, Rita Gerivaz, Ana Tomé, Sofia Afonso, Maria Pedro Silveira, Patrícia Sousa, Rui Bergantim, Cristina João

Research output: Contribution to journalReview articlepeer-review

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Abstract

Multiple myeloma (MM) is a very heterogeneous disease with multiple symptoms and clinical manifestations. MM affects mainly elderly patients and is difficult to manage in the presence of comorbidities, polypharmacy, frailty and adverse events of disease-targeted drugs. The rapid changes in MM treatment resulting from constant innovations in this area, together with the introduction of numerous new drugs with distinct mechanisms of action and toxicity profiles, have led to an increased complexity in the therapeutic decision-making and patient management processes. The prolonged exposure to novel agents, sometimes in combination with conventional therapies, makes this management even more challenging. A careful balance between treatment efficacy and its tolerability should be considered for every patient. During treatment, a close monitoring of comorbidities, disease-related manifestations and treatment side effects is recommended, as well as a proactive approach, with reinforcement of information and patient awareness for the early recognition of adverse events, allowing prompt therapeutic adjustments. In this review, we discuss various issues that must be considered in the treatment of MM patients, while giving practical guidance for monitoring, prevention and management of myeloma-related manifestations and treatment-related toxicities.

Original languageEnglish
Article number1282300
JournalFrontiers in Oncology
Volume14
DOIs
Publication statusPublished - Mar 2024

Keywords

  • anticancer drug toxicities
  • cancer management
  • delivery of health care
  • multiple myeloma
  • myeloma-related manifestations
  • real life practical considerations

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