Cáceres William, Santiago Karen, Paulo Liza, Román Jaime
VA Caribbean Healthcare System, San Juan, Puerto Rico 00921.
Bol Asoc Med P R. 2009 Apr-Jun;101(2):50-2.
Patients with multiple myeloma (MM) have a high rate of infectious complications and symptomatic anemia. Emerging antineoplastic therapies are resulting in a better response, but still quality of life and potentially survival can be significantly affected by these complications. Multiple cytokines and an impaired immunologic system are involved in the development of these complications. Emerging therapies and guidelines will be reviewed taking in consideration the benefits versus risks of those strategies. The beneficial effect of recombinant human erythropoietin (EPO) and darbepoietin alpha in MM patients have been confirmed in several trials. Evidenced-based guidelines for the use of EPO in patients with cancer should be closely followed to ensure correct use of erythropoiesis stimulating agents. Infection, despite being the most common cause of morbidity and mortality, can be controlled by prompt recognition and proper prophylaxis.Supportive care is an important adjunct to cancer therapy. Adequate use of pharmacologic strategies to control anemia and prevent or treat infectious complications will result in benefit to MM patients.
多发性骨髓瘤（MM）患者发生感染并发症和症状性贫血的几率很高。新兴的抗肿瘤疗法正在带来更好的疗效，但这些并发症仍可能显著影响患者的生活质量和潜在生存期。多种细胞因子和免疫系统受损与这些并发症的发生有关。将在考虑这些策略的利弊的基础上，对新兴疗法和指南进行综述。重组人促红细胞生成素（EPO）和达比泊汀α在MM患者中的有益作用已在多项试验中得到证实。应严格遵循基于证据的癌症患者使用EPO的指南，以确保正确使用促红细胞生成刺激剂。感染虽是发病和死亡的最常见原因，但通过及时识别和适当预防可得到控制。支持性护理是癌症治疗的重要辅助手段。合理使用药物策略来控制贫血以及预防或治疗感染并发症将使MM患者受益。
