a Division of Hematology, Department of Internal Medicine , Rush University Medical Center , Chicago , IL , USA.
b Division of Cardiology, Department of Internal Medicine , Rush University Medical Center , Chicago , IL , USA.
Expert Rev Hematol. 2018 Dec;11(12):957-973. doi: 10.1080/17474086.2018.1538777. Epub 2018 Dec 4.
: Multiple three drug combination regimens have been approved for the treatment of multiple myeloma in the last few years. Triplets have become the new standard of care for transplant eligible and ineligible patients with newly diagnosed as well as relapsed multiple myeloma. Novel agents have a unique profile of side effects. The management of toxicities is important to maintain quality of life and maximize treatment duration and benefit. : This article reviews efficacy data, incidence of key adverse events and provide recommendations and expert opinion regarding how to manage common toxicities in triplet therapies. Relevant publications and abstracts were searched in PubMed, ASH, ASCO and EHA meetings. Guidelines from IMWG, NCCN, ESMO and ASCO, published trial protocols and prescribing information were used to formulate recommendations for the management of toxicities. : Side effects are a critical factor guiding the selection of optimal chemotherapy regimens for multiple myeloma. The majority of toxicities encountered with triplet therapies are reversible and can be readily managed with supportive care and dose modifications.
: 在过去的几年中，已经批准了多种三联药物组合方案来治疗多发性骨髓瘤。三联方案已成为新的标准治疗方法，适用于新诊断和复发的多发性骨髓瘤患者，无论其是否适合进行移植。新型药物具有独特的副作用谱。为了维持生活质量并最大限度地延长治疗时间和获益，管理毒性反应非常重要。 : 本文综述了三联疗法的疗效数据、关键不良事件的发生率，并就如何管理三联疗法中的常见毒性反应提供了建议和专家意见。在 PubMed、ASH、ASCO 和 EHA 会议上搜索了相关出版物和摘要。使用 IMWG、NCCN、ESMO 和 ASCO 的指南、已发表的试验方案和说明书来制定毒性反应管理的建议。 : 副作用是指导多发性骨髓瘤最佳化疗方案选择的关键因素。三联疗法中遇到的大多数毒性反应是可逆的，可以通过支持性护理和剂量调整来很好地管理。
