Chapter 5 – Treatment of relapsed multiple myeloma

Contributor: Michel Delforge

6 – Supportive care

At any stage during their disease, MM patients will require optimal supportive care in addition to their anti-myeloma therapy. It is beyond doubt that MM remains a highly symptomatic disease with skeletal symptoms, infections, and kidney disorders as the most relevant clinical problems not only at diagnosis but also at relapse. Therefore, during all disease phases, physicians need to remain vigilant for disease-related, in addition to treatment-related, complications [25]. Maybe one of the most difficult decisions to take for any individual MM patient is not when to start but when to stop treatment and switch to palliative care. This should be decided on an individual basis after carefully balancing the potential benefit of continuing active treatment versus treatment discontinuation and maximizing the efforts for symptom control and palliation.