Snowden John A, Greenfield Diana M, Bird Jennifer M, Boland Elaine, Bowcock Stella, Fisher Abigail, Low Eric, Morris Monica, Yong Kwee, Pratt Guy
Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
Br J Haematol. 2017 Mar;176(6):888-907. doi: 10.1111/bjh.14514. Epub 2017 Jan 20.
A growing population of long-term survivors of myeloma is now accumulating the 'late effects' not only of myeloma itself, but also of several lines of treatment given throughout the course of the disease. It is thus important to recognise the cumulative burden of the disease and treatment-related toxicity in both the stable and active phases of myeloma, some of which is unlikely to be detected by routine monitoring. We summarise here the evidence for the key late effects in long-term survivors of myeloma, including physical and psychosocial consequences (in Parts 1 and 2 respectively), and recommend the use of late-effects screening protocols in detection and intervention. The early recognition of late effects and effective management strategies should lead to an improvement in the management of myeloma patients, although evidence in this area is currently limited and further research is warranted.
骨髓瘤长期存活者的数量日益增多，他们不仅积累了骨髓瘤本身的“晚期效应”，还积累了病程中接受的多种治疗方法所带来的“晚期效应”。因此，认识到骨髓瘤稳定期和活动期疾病的累积负担以及治疗相关毒性非常重要，其中一些毒性不太可能通过常规监测检测到。我们在此总结骨髓瘤长期存活者关键晚期效应的证据，包括身体和心理社会后果（分别在第1部分和第2部分），并建议在检测和干预中使用晚期效应筛查方案。晚期效应的早期识别和有效的管理策略应能改善骨髓瘤患者的管理，尽管该领域目前的证据有限，仍有必要进行进一步研究。
