Suboptimal Implementation of Supportive Care in Older Patients With Multiple Myeloma

According to findings from a study published in Cancer on the utilization of specific supportive care measures in older patients with multiple myeloma, only approximately two-thirds of patients received guideline-concordant administration of a bone-modifying agent.

The course of treatment for patients with multiple myeloma is typically characterized by the administration of multiple lines of therapy associated with periods of sustained response or remission followed by eventual relapse. Hence, the quality of life in these patients can be diminished by both the cumulative adverse effects of treatment as well as manifestations of the disease, including bone lesions, skeletal-related events, and an increased risk of infection. Furthermore, older age at diagnosis of multiple myeloma is another factor likely to magnify the negative impact of treatment toxicity and disease burden, and the majority of patients with this disease are diagnosed at 65 years or older.

A number of clinical guidelines covering the diagnosis and treatment of multiple myeloma, including those from the National Comprehensive Cancer Network, recommend specific supportive-care measures for these patients. These recommendations include vaccination against influenza for all patients with multiple myeloma, use of a bone-modifying agent in all patients undergoing active treatment, and prophylactic antiviral medication for those receiving a proteasome inhibitor.

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