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Br J Haematol ; 154(1): 76-103, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21517805

RESUMO

Supportive care plays an increasingly important role in the modern management of multiple myeloma. While modern treatments have significantly prolonged overall and progression free survival through improved disease control, the vast majority of patients remain incurable, and live with the burden of the disease itself and the cumulative side effects of treatments. Maintenance of quality of life presents challenges at all stages of the disease from diagnosis through the multiple phases of active treatment to the end of life. Written on behalf of the British Committee for Standards in Haematology (BCSH) and the UK Myeloma Forum (UKMF), these evidence based guidelines summarize the current national consensus for supportive and symptomatic care in multiple myeloma in the following areas; pain management, peripheral neuropathy, skeletal complications, infection, anaemia, haemostasis and thrombosis, sedation, fatigue, nausea, vomiting, anorexia, constipation, diarrhoea, mucositis, bisphosphonate-induced osteonecrosis of the jaw, complementary therapies, holistic needs assessment and end of life care. Although most aspects of supportive care can be supervised by haematology teams primarily responsible for patients with multiple myeloma, multidisciplinary collaboration involving specialists in palliative medicine, pain management, radiotherapy and surgical specialities is essential, and guidance is provided for appropriate interdisciplinary referral. These guidelines should be read in conjunction with the BCSH/UKMF Guidelines for the Diagnosis and Management of Multiple Myeloma 2011.


Assuntos
Mieloma Múltiplo/complicações , Anemia/etiologia , Anemia/terapia , Conservadores da Densidade Óssea/efeitos adversos , Terapias Complementares/métodos , Difosfonatos/efeitos adversos , Medicina Baseada em Evidências/métodos , Técnicas Hemostáticas , Humanos , Arcada Osseodentária/efeitos dos fármacos , Mieloma Múltiplo/terapia , Infecções Oportunistas/complicações , Infecções Oportunistas/prevenção & controle , Osteonecrose/induzido quimicamente , Osteonecrose/terapia , Dor/diagnóstico , Dor/etiologia , Manejo da Dor , Medição da Dor/métodos , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/terapia , Assistência Terminal/métodos , Trombose/etiologia , Trombose/terapia
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