Noonan Kimberly, Rome Sandra, Faiman Beth
Dana-Farber Cancer Institute, Boston, Massachusetts.
Cedars-Sinai Medical Center, Los Angeles, California.
J Adv Pract Oncol. 2022 Jul;13(Suppl 4):15-21. doi: 10.6004/jadpro.2022.13.5.11. Epub 2022 Jul 28.
Multiple myeloma (MM) is a relapsing disease for many patients with multiple myeloma. At relapse, patients have many options for treatment once disease has progressed. Advanced practitioners are well suited to set expectations for ongoing therapy and underscore the importance of continued disease monitoring. Criteria for relapsed myeloma rely on biomarker and radiologic imaging, as well as physical exam and awareness of new bone pain or changes in physiologic function. The treatment of patients with relapsed MM requires a personalized approach and considers patient desires in regard to aggressiveness of therapy and willingness to participate in a clinical trial. The prognosis of patients with relapsed MM depends upon disease characteristics at baseline or throughout, as patients may acquire adverse cytogenetic abnormalities through various lines of treatment. Empowering patients to understand their diagnosis, interpret labs, and take an active role in treatment selection through shared decision-making can improve patients' quality of life and enhance adherence.
对于许多多发性骨髓瘤患者来说,多发性骨髓瘤(MM)是一种会复发的疾病。复发时,一旦疾病进展,患者有多种治疗选择。高级执业医师非常适合为持续治疗设定预期,并强调持续疾病监测的重要性。复发骨髓瘤的标准依赖于生物标志物、放射影像学检查,以及体格检查和对新出现的骨痛或生理功能变化的了解。复发MM患者的治疗需要个性化方法,并考虑患者在治疗积极性和参与临床试验意愿方面的期望。复发MM患者的预后取决于基线时或整个病程中的疾病特征,因为患者可能会在多线治疗过程中出现不良细胞遗传学异常。通过共同决策让患者了解自己的诊断、解读检查结果并在治疗选择中发挥积极作用,可以提高患者的生活质量并增强依从性。