Goede Valentin
Sektion für Onkologische Geriatrie, St. Marien-Hospital, Kunibertskloster 11-13, 50668, Köln, Deutschland.
Z Gerontol Geriatr. 2020 May;53(3):263-272. doi: 10.1007/s00391-020-01701-w. Epub 2020 Mar 4.
Multiple myeloma is an age-associated disease. In aged and multimorbid patients the diagnosis could be delayed due to the diversity of symptoms of this disease. Key diagnostic steps are the detection of an M protein as a surrogate of clonal plasma cell proliferation and evaluation of the CRAB criteria (hypercalcemia, renal insufficiency, anemia, bone lesions). The individual prognosis and vulnerability to treatment complications can be assessed by use of validated scores. Following the introduction of many new drugs, vulnerable aged patients with multiple myeloma can also be very effectively treated with modern (partially chemotherapy-free) combination treatment and additional supportive care. Successful management of aged and multimorbid patients with multiple myeloma is not the sole task of the treating hemato-oncologist but also mostly requires the inclusion of general practitioners and geriatricians.
多发性骨髓瘤是一种与年龄相关的疾病。在老年和患有多种疾病的患者中，由于该疾病症状的多样性，诊断可能会延迟。关键的诊断步骤是检测M蛋白作为克隆性浆细胞增殖的替代指标，并评估CRAB标准（高钙血症、肾功能不全、贫血、骨病变）。个体预后和对治疗并发症的易感性可以通过使用经过验证的评分来评估。随着许多新药的引入，患有多发性骨髓瘤的老年脆弱患者也可以通过现代（部分无化疗）联合治疗和额外的支持性护理得到非常有效的治疗。成功管理患有多发性骨髓瘤的老年和患有多种疾病的患者不仅是血液肿瘤治疗医生的唯一任务，而且大多还需要全科医生和老年病医生的参与。
