Evidence-Based Guidelines for Preventing and Managing Side Effects of Multiple Myeloma

Bertolotti, P; Pierre, Amy; Rome, Sandra; Faiman, Beth

doi:10.1016/j.soncn.2017.05.008

Cited by 7 publications

(5 citation statements)

References 76 publications

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“…18,19 Kemik iliğinde gelişen anormal monoklonal protein hücreleri, çoklu organ yetersizliğine neden olmakta ve hastaların yaşam kalitesini olumsuz etkilemektedir. 20,21 Hastalarda gelişen acil durumlar; mekanik, metabolik ve hematolojik olarak ortaya çıkmaktadır. 13,[21][22][23][24][25] Multipl miyelom nedeniyle ortaya çıkan acil durumların yıkıcı etkilerinin bilinmesi, erken tanımlanabilmesi ve etkin yönetiminin sağlanması, hastaların yaşam kali-tesinin iyileşmesi ve sağkalım süresinin artması açısından büyük önem taşımaktadır.…”

Section: Multi̇pl Mi̇yelom Hastalarinda Onkoloji̇k Aci̇llerunclassified

“…19,63 Patofizyoloji Trombositopeni, kemoterapi ile ilişkili olabileceği gibi splenomegali, komorbiditeler ve kullanılan ilaçlara bağlı olarak gelişen periferik yıkım veya sekestrasyo-nun bir sonucu olarak görülebilmektedir. 19,20 Kemik iliğinde çok sayıda bulunan miyelom hücreleri ve tedavide kullanılan proteazom inhibitörleri, trombositopeni patogenezinde önemli rol oynamaktadır. 19…”

Section: Kanama Ri̇ski̇unclassified

“…Trombositopeni, hastalarda kanamaya neden olmaktadır. 19,20 Bu kanamalar; ekimoz, peteşi, burun kanaması, hemoptizi, hematüri, hematemez, melena, vajinal kanama, cilt lezyonlarından veya damar erişim hatlarından sızıntı şeklinde ortaya çıkabilmektedir. Kanama, serebral veya gastrointestinal kanama şeklinde ortaya çıkabilmektedir.…”

Section: Belirti Ve Bulgularunclassified

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Evidence-Based Medical Recommendations and Nursing Management for Oncological Emergencies in Patients with Multiple Myelom: Traditional Review

Metin¹,

Uğur²

2022

Turkiye Klinikleri J Nurs Sci

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ÖZET Kanser, dünya çapında ölüm nedenleri arasında 2. sırada yer alan ve insidansı her geçen gün artan önemli bir sağlık sorunudur. Hematolojik kanserler arasında yer alan ve yaklaşık olarak tüm malignitelerin %10'unu oluşturan multipl miyelom, anormal monoklonal protein sentezi, immunoglobulin ve hafif serbest zincir artışı ile karakterize progresif neoplastik plazma hücrelerinin bir hastalığıdır. Kemik iliğinde gelişen anormal monoklonal protein hücreleri, çoklu organ yetersizliğime neden olmakta ve hastaların yaşam kalitesini olumsuz etkilemektedir. Miyelom tanısı alan ve tedavi gören kişiler metabolik, kardiyojenik, nörolojik olaylar ve enfeksiyon gibi yaşamlarını tehdit eden bazı komplikasyonların gelişmesi yönünden risk altındadır. Onkolojik aciller olarak adlandırılan bu durum, bilinen bir malignitenin ilerlemesinden kaynaklanan veya önceden teşhis edilmemiş bir malignitenin ilk belirtisi olarak ortaya çıkan geniş bir hastalık yelpazesini temsil etmektedir. Multipl miyelom nedeniyle hastalarda gelişen acil durumlar; mekanik, metabolik ve hematolojik olarak ortaya çıkmaktadır. En sık görülen mekanik aciller arasında, %7,8 oranında spinal kord basısı ve %39,2'sinde vertebral kırık yer almaktadır. Metabolik aciller arasında en sık %54 oranında hafif serbest zincir artışına bağlı akut renal yetersizlik, %30 oranında hiperkalsemi ve %18,1'inde tümör lizis sendromu görülmektedir. Hematolojik aciller arasında ise %72 oranında anemi, %39-%50 oranında nötropeni ve %18'inde trombositopeni yer almaktadır. Multipl miyelom nedeniyle ortaya çıkan acil durumların yıkıcı etkilerinin bilinmesi, erken tanımlanabilmesi ve etkin yönetiminin sağlanması hastaların yaşam kalitesinin iyileşmesi ve sağkalım süresinin artması açısından büyük önem taşımaktadır. Bu nedenle bu derlemede, multipl miyelom hastalarında onkolojik acil durumlara ilişkin kanıt temelli tıbbi önerilerin sunulması ve multipl miyelom hastalarında onkolojik acil durumlarda hemşirelik yönetiminin ele alınması amaçlanmaktadır.Anah tar Ke li me ler: Multipl miyelom; onkoloji hemşireliği; aciller; kanıta dayalı hemşirelik ABS TRACT Cancer is an important health problem that ranks second among the causes of death worldwide and its incidence is increasing day by day. Multiple myeloma, which is among the hematological cancers and constitutes approximately 10% of all malignancies, is a disease of progressive neoplastic plasma cells characterized by abnormal monoclonal protein synthesis, immunoglobulin and light free chain increase. Abnormal monoclonal protein cells developing in the bone marrow cause multi-organ failure and adversely affect the quality of life of patients. People diagnosed and treated for myeloma are at risk of developing some life-threatening complications such as metabolic, cardiogenic, neurological events and infection. These socalled oncological emergencies represent a wide spectrum of diseases arising from the progression of a known malignancy or presenting as the first manifestation of a previously undiagnosed malignancy. Emergencies developing in...

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Section: Multi̇pl Mi̇yelom Hastalarinda Onkoloji̇k Aci̇llerunclassified

Section: Kanama Ri̇ski̇unclassified

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Evidence-Based Medical Recommendations and Nursing Management for Oncological Emergencies in Patients with Multiple Myelom: Traditional Review

Metin¹,

Uğur²

2022

Turkiye Klinikleri J Nurs Sci

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“…The rapid growth of myeloma cells and the challenge of complete resection contribute to the incurable nature of multiple myeloma. Non-targeted drugs, while effective, can also harm normal healthy cells, leading to adverse effects such as gastrointestinal problems (nausea, vomiting, diarrhea, and constipation) [ 57 ], myelosuppression (reduction in white blood cells and platelets), alopecia, anemia, liver and kidney impairment, and an increased risk of infections [ 58 , 59 ]. However, targeted drugs offer a promising avenue for improving treatment efficacy and reducing adverse effects by selectively targeting specific molecules or pathways involved in myeloma cell survival and proliferation.…”

Section: Introductionmentioning

confidence: 99%

Multiple myeloma: signaling pathways and targeted therapy

Lu,

Yang,

et al. 2024

Mol Biomed

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Multiple myeloma (MM) is the second most common hematological malignancy of plasma cells, characterized by osteolytic bone lesions, anemia, hypercalcemia, renal failure, and the accumulation of malignant plasma cells. The pathogenesis of MM involves the interaction between MM cells and the bone marrow microenvironment through soluble cytokines and cell adhesion molecules, which activate various signaling pathways such as PI3K/AKT/mTOR, RAS/MAPK, JAK/STAT, Wnt/β-catenin, and NF-κB pathways. Aberrant activation of these pathways contributes to the proliferation, survival, migration, and drug resistance of myeloma cells, making them attractive targets for therapeutic intervention. Currently, approved drugs targeting these signaling pathways in MM are limited, with many inhibitors and inducers still in preclinical or clinical research stages. Therapeutic options for MM include non-targeted drugs like alkylating agents, corticosteroids, immunomodulatory drugs, proteasome inhibitors, and histone deacetylase inhibitors. Additionally, targeted drugs such as monoclonal antibodies, chimeric antigen receptor T cells, bispecific T-cell engagers, and bispecific antibodies are being used in MM treatment. Despite significant advancements in MM treatment, the disease remains incurable, emphasizing the need for the development of novel or combined targeted therapies based on emerging theoretical knowledge, technologies, and platforms. In this review, we highlight the key role of signaling pathways in the malignant progression and treatment of MM, exploring advances in targeted therapy and potential treatments to offer further insights for improving MM management and outcomes.

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“…The most common symptoms of MM include disseminated osteolysis and, consequently, bone fragility, anemia, and hypercalcemia as well as renal dysfunction or even terminal renal failure [4]. Moreover, intensive drug regimens and radiation increase severe burden of fatigue and polyneuropathy and a significant reduction in physical capacity and health-related quality of life [2,5,6].…”

Section: Introductionmentioning

confidence: 99%

Clinical exercise therapy program with multiple myeloma patients: Impacts on feasibility, adherence and efficacy

Wefelnberg

Niels

Jundt

et al. 2022

Support Care Cancer

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Purpose Multiple myeloma (MM) is a severe hemato-oncological disease with high mortality and increasing incidence rate. Since evidence on exercise therapy in MM patients remains limited, this study examines feasibility, adherence, and efficacy based on real-life data from an oncologic care structure. Methods A data evaluation of MM patients who participated in the oncologic exercise and movement therapy (OTT) at the Cologne University Hospital between 2012 and 2019 was conducted. The patient flow was incrementally reduced to four cohorts, intention-to-treat cohort (ITTC), safety cohort (SC), adherence cohort (AC), and efficacy cohort (EC). Cohorts were evaluated descriptively and by means of correlation analysis as well as group and time comparisons. Results Thirty patients registered at the OTT between 2012 and 2019 (ITTC). The SC (N = 26) attended exercise therapy on average about one session per week over a period of 8 months. One-third dropped out within 3 months. In the AC (N = 15), BMI at baseline exhibited a strong and very significant negative correlation with exercise adherence. In the EC (N = 8), a significant improvement in physical functioning and a tendency towards significance in fatigue reduction between two measurement points was observed. No adverse events were documented. Conclusions The present observatory study reveals safety and feasibility while indicating adherence and efficacy of exercising MM patients under real-life therapy circumstances. Found obstacles to exercising as well as improvements in questionnaire scale scores need to be further examined in confirmatory study designs.

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Evidence-Based Guidelines for Preventing and Managing Side Effects of Multiple Myeloma

Cited by 7 publications

References 76 publications

Evidence-Based Medical Recommendations and Nursing Management for Oncological Emergencies in Patients with Multiple Myelom: Traditional Review

Evidence-Based Medical Recommendations and Nursing Management for Oncological Emergencies in Patients with Multiple Myelom: Traditional Review

Multiple myeloma: signaling pathways and targeted therapy

Clinical exercise therapy program with multiple myeloma patients: Impacts on feasibility, adherence and efficacy

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