Materiały źródłowe

• #1 Multiple Myeloma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0315/p373.html

  Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. Patients older than 65 years account for 85% of those diagnosed with multiple myeloma, and there is a twofold increased incidence in blacks compared with whites. Patients may present with bone pain or with symptoms that are often nonspecific, such as nausea, vomiting, malaise, weakness, recurrent infections, and weight loss. Many patients present with only laboratory abnormalities, such as anemia, renal disease, and elevated protein levels. The diagnosis of multiple myeloma requires increased numbers of immature, abnormal, or atypical plasma cells in the bone marrow; a monoclonal protein in the serum or urine; or characteristic bone lesions. The diagnostic workup in a patient with suspected multiple myeloma should include a complete blood count with differential; serum chemistries; creatinine, lactate dehydrogenase, and beta2-microglobulin tests; immunoglobulin studies; skeletal survey; and bone marrow evaluation.

• #2 Multiple Myeloma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0315/p373.html

  Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. Patients older than 65 years account for 85% of those diagnosed with multiple myeloma, and there is a twofold increased incidence in blacks compared with whites. Patients may present with bone pain or with symptoms that are often nonspecific, such as nausea, vomiting, malaise, weakness, recurrent infections, and weight loss. Many patients present with only laboratory abnormalities, such as anemia, renal disease, and elevated protein levels. The diagnosis of multiple myeloma requires increased numbers of immature, abnormal, or atypical plasma cells in the bone marrow; a monoclonal protein in the serum or urine; or characteristic bone lesions. The diagnostic workup in a patient with suspected multiple myeloma should include a complete blood count with differential; serum chemistries; creatinine, lactate dehydrogenase, and beta2-microglobulin tests; immunoglobulin studies; skeletal survey; and bone marrow evaluation.

• #3 Multiple Myeloma in Underserved Populations | The MMRF

  https://themmrf.org/multiple-myeloma/underserved-populations/

  Multiple myeloma is twice as common and twice as deadly in Black patients compared to White patients. […] Over the last two decades, treatment results for patients with multiple myeloma have improved considerably largely because of an unprecedented number of new myeloma drugs becoming available. […] Black male multiple myeloma patient. […] Compared with White patients, Black patients tend to have an earlier average age at diagnosis by 5 to 10 years. […] Issues contributing to care disparities in certain racial and ethnic minorities, including Black and Hispanic myeloma patients, are institutional racism in healthcare delivery, lack of access to care and services, and lack of awareness of risk factors. […] Studies have shown that when Black and Hispanic myeloma patients receive appropriate, timely care, they can achieve the same results as other myeloma patient populations with response rates, survival, and total healthcare costs that are similar across all myeloma patient populations, regardless of race.

• #4

  https://www.cancer.northwestern.edu/types-of-cancer/multiple-myeloma/index.html

  Myeloma is a cancer of the plasma cells in the bone marrow, the spongy tissue inside of bones. Plasma cells are a part of the body’s immune system and produce antibodies that help the body fight infection. Abnormal plasma cells can suppress the growth of other cells in the bone that produce red blood cells, white blood cells and platelets. This suppression may result in anemia (from a shortage of red blood cells), excessive bleeding from cuts (from a shortage of platelets) and a decreased ability to fight infection (from a shortage of white blood cells). Myeloma often causes structural bone damage resulting in painful fractures. […] Our experts work together in a multidisciplinary team (including dedicated, talented nursing staff and Lurie Cancer Centers Supportive Oncology Team) to help create a comprehensive, individualized treatment plan and provide you with exceptional support. […] Stem cell transplants are regularly used to treat multiple myeloma; visit the program’s page to learn more.

• #5 Multiple Myeloma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/multiple-myeloma/?srsltid=AfmBOopQ6SLqme9rXL8gPr9HzyGy8v4A-uRh1LF-keEC5PDdxZVH70-J

  Multiple myeloma is a malignancy of the plasma cells that develops in the bone marrow. […] General management includes the following: Administration of medications to maintain patients comfort. […] Assessment of body systems that may be affected by diagnosis (renal, skeletal, circulatory). […] Refer patient to oncologist, radiation oncologist. […] Watchful waiting for newly diagnosed with indolent disease. […] Monitor the condition in the early stages without treatment (asymptomatic). […] Transplant eligibility for those with symptomatic disease based on comorbidities and performance status. […] Encourage activities to maintain strength. […] Well balanced nutrition with increased caloric intake during treatment of with patients losing weight from disease process. […] Increase fluid intake to avoid renal complications.

• #6 Multiple Myeloma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0315/p373.html

  Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. Patients older than 65 years account for 85% of those diagnosed with multiple myeloma, and there is a twofold increased incidence in blacks compared with whites. Patients may present with bone pain or with symptoms that are often nonspecific, such as nausea, vomiting, malaise, weakness, recurrent infections, and weight loss. Many patients present with only laboratory abnormalities, such as anemia, renal disease, and elevated protein levels. The diagnosis of multiple myeloma requires increased numbers of immature, abnormal, or atypical plasma cells in the bone marrow; a monoclonal protein in the serum or urine; or characteristic bone lesions. The diagnostic workup in a patient with suspected multiple myeloma should include a complete blood count with differential; serum chemistries; creatinine, lactate dehydrogenase, and beta2-microglobulin tests; immunoglobulin studies; skeletal survey; and bone marrow evaluation.

• #7 Multiple Myeloma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0315/p373.html

  Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. Patients older than 65 years account for 85% of those diagnosed with multiple myeloma, and there is a twofold increased incidence in blacks compared with whites. Patients may present with bone pain or with symptoms that are often nonspecific, such as nausea, vomiting, malaise, weakness, recurrent infections, and weight loss. Many patients present with only laboratory abnormalities, such as anemia, renal disease, and elevated protein levels. The diagnosis of multiple myeloma requires increased numbers of immature, abnormal, or atypical plasma cells in the bone marrow; a monoclonal protein in the serum or urine; or characteristic bone lesions. The diagnostic workup in a patient with suspected multiple myeloma should include a complete blood count with differential; serum chemistries; creatinine, lactate dehydrogenase, and beta2-microglobulin tests; immunoglobulin studies; skeletal survey; and bone marrow evaluation.

• #8 Multiple Myeloma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0315/p373.html

  Most patients with multiple myeloma will receive thromboprophylaxis, bisphosphonate therapy, and prophylaxis against infection at some point in their treatment. Family physicians play a role in assessing these patients for infection, adverse treatment effects, and renal and thrombotic complications, and in managing issues related to pain, nutrition, and psychosocial support. […] Patients with multiple myeloma should receive bisphosphonate therapy (i.e., zoledronic acid [Reclast] or pamidronate) when first diagnosed. Patients with multiple myeloma should receive thromboprophylaxis when first diagnosed. […] Bone disease develops in 80% to 90% of patients with myeloma and includes bone pain, pathologic fractures (40%), spinal cord compression (5%), and hypercalcemia. These skeletal-related events compromise mobility and independence, adversely affect quality of life, and are associated with decreased survival. The 2013 IMWG consensus statement on the treatment of bone disease recommends intravenous zoledronic acid (Reclast) or pamidronate for all patients with multiple myeloma who are receiving treatment, regardless of the presence of bone lesions.

• #9 Multiple Myeloma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0315/p373.html

  Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. Patients older than 65 years account for 85% of those diagnosed with multiple myeloma, and there is a twofold increased incidence in blacks compared with whites. Patients may present with bone pain or with symptoms that are often nonspecific, such as nausea, vomiting, malaise, weakness, recurrent infections, and weight loss. Many patients present with only laboratory abnormalities, such as anemia, renal disease, and elevated protein levels. The diagnosis of multiple myeloma requires increased numbers of immature, abnormal, or atypical plasma cells in the bone marrow; a monoclonal protein in the serum or urine; or characteristic bone lesions. The diagnostic workup in a patient with suspected multiple myeloma should include a complete blood count with differential; serum chemistries; creatinine, lactate dehydrogenase, and beta2-microglobulin tests; immunoglobulin studies; skeletal survey; and bone marrow evaluation.

• #10 Multiple Myeloma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/multiple-myeloma/?srsltid=AfmBOopQ6SLqme9rXL8gPr9HzyGy8v4A-uRh1LF-keEC5PDdxZVH70-J

  Multiple myeloma is a malignancy of the plasma cells that develops in the bone marrow. […] General management includes the following: Administration of medications to maintain patients comfort. […] Assessment of body systems that may be affected by diagnosis (renal, skeletal, circulatory). […] Refer patient to oncologist, radiation oncologist. […] Watchful waiting for newly diagnosed with indolent disease. […] Monitor the condition in the early stages without treatment (asymptomatic). […] Transplant eligibility for those with symptomatic disease based on comorbidities and performance status. […] Encourage activities to maintain strength. […] Well balanced nutrition with increased caloric intake during treatment of with patients losing weight from disease process. […] Increase fluid intake to avoid renal complications.

• #11 Multiple Myeloma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0315/p373.html

  Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. Patients older than 65 years account for 85% of those diagnosed with multiple myeloma, and there is a twofold increased incidence in blacks compared with whites. Patients may present with bone pain or with symptoms that are often nonspecific, such as nausea, vomiting, malaise, weakness, recurrent infections, and weight loss. Many patients present with only laboratory abnormalities, such as anemia, renal disease, and elevated protein levels. The diagnosis of multiple myeloma requires increased numbers of immature, abnormal, or atypical plasma cells in the bone marrow; a monoclonal protein in the serum or urine; or characteristic bone lesions. The diagnostic workup in a patient with suspected multiple myeloma should include a complete blood count with differential; serum chemistries; creatinine, lactate dehydrogenase, and beta2-microglobulin tests; immunoglobulin studies; skeletal survey; and bone marrow evaluation.

• #12 Disease and Symptom Care: A Focus on Specific Needs of Patients With Multiple Myeloma | Oncology Nursing Society

  https://www.ons.org/disease-and-symptom-care-focus-specific-needs-patients-multiple-myeloma

  Patients with multiple myeloma (MM) often deal with short- and long-term side effects of the treatment and disease sequelae. […] Guidelines for nursing management of side effects in patients with MM are absent or require updating. […] Nurses function in a range of capacities on the front lines of patient care and hold vital roles, such as coordinators and facilitators of care. […] Therefore, nurses are well positioned to identify, intervene in, and effectively manage disease- and treatment-related symptoms in patients with MM, improving MM treatment quality, treatment adherence, and patient QOL. […] Effective symptom management is a critical component of treatment adherence in MM. […] The IMF NLB aims to improve the care and self-care of patients with MM and to create new professional activities, such as this supplement, and address the unmet needs of patients and the nurses who care for them. […] It is the hope of the IMF NLB that these peer-reviewed, evidenced-based recommendations will be accepted as a standard of nursing care for patients to manage short- and long-term side effects and symptoms and improve QOL.

• #13 Disease and Symptom Care: A Focus on Specific Needs of Patients With Multiple Myeloma | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/5/supplement-october-2017-multiple-myeloma/disease-and-symptom-care

  Patients with multiple myeloma (MM) often deal with short- and long-term side effects of the treatment and disease sequelae. […] This article provides background surrounding this supplements development and describes the importance of symptom assessment and management. […] Guidelines for nursing management of side effects in patients with MM are absent or require updating. […] The International Myeloma Foundation Nurse Leadership Board aimed to address symptoms that patients with MM often self-manage and provide evidence-based updates for nursing symptom care in MM. […] Nurses function in a range of capacities on the front lines of patient care and hold vital roles, such as coordinators and facilitators of care. […] Therefore, nurses are well positioned to identify, intervene in, and effectively manage disease- and treatment-related symptoms in patients with MM, improving MM treatment quality, treatment adherence, and patient QOL.

• #14 Disease and Symptom Care: A Focus on Specific Needs of Patients With Multiple Myeloma | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/5/supplement-october-2017-multiple-myeloma/disease-and-symptom-care

  Patients with multiple myeloma (MM) often deal with short- and long-term side effects of the treatment and disease sequelae. […] This article provides background surrounding this supplements development and describes the importance of symptom assessment and management. […] Guidelines for nursing management of side effects in patients with MM are absent or require updating. […] The International Myeloma Foundation Nurse Leadership Board aimed to address symptoms that patients with MM often self-manage and provide evidence-based updates for nursing symptom care in MM. […] Nurses function in a range of capacities on the front lines of patient care and hold vital roles, such as coordinators and facilitators of care. […] Therefore, nurses are well positioned to identify, intervene in, and effectively manage disease- and treatment-related symptoms in patients with MM, improving MM treatment quality, treatment adherence, and patient QOL.

• #15 The Pivotal Role of Oncology Nurses in the Care of Patients with Multiple Myeloma – Journal of Oncology Navigation & Survivorship

  https://www.jons-online.com/issues/2016/december-2016-vol-7-no-11/the-pivotal-role-of-oncology-nurses-in-the-care-of-patients

  Considering that nurses are the healthcare professionals with the most interpersonal contact with the patient, they play many vital roles in the care of their patients, including that of caregiver, communicator, educator, and advocate. […] Therefore, from their position at the frontline of treating patients with MM, nurses must be understanding and empathetic to the unique needs, challenges, and viewpoints of patients throughout the disease continuum, from diagnosis through survivorship. […] This synthesis of the patient voice provides invaluable and actionable insights into the challenges that patients with MM face, so that nurses may direct their efforts to improving the care of patients with MM. […] Notably, the group indicated that there was considerable disparity in the knowledge base of nurses who are practicing in large institutions and those practicing in community oncology centers. This was a source of considerable concern and frustration for patients, given their greater interaction with nurses than with other healthcare professionals.

• #16 Current Diagnosis and Management of Multiple Myeloma

  https://www.cancernetwork.com/view/current-diagnosis-and-management-multiple-myeloma

  At every encounter, nurses should evaluate myeloma patients abilities to perform activities of daily living in a safe manner, so that falls and fractures are avoided. […] Nurses are in a unique position to assess and explore pain in a stepwise and ongoing fashion, using verbal and nonverbal pain scales and grading systems. […] Nursing care goals are to maintain or improve kidney function. […] Nurses can help to guide the myeloma patient and family through this long journey. […] Understanding the disease and its treatments allows the practitioner to ask pointed questions as part of the assessment. […] Advocating quality of life for patients includes patient education and support and coaching them to be self-advocates. […] Through exceptional care, oncology nurses can advocate for the patient with multiple myeloma to optimize treatment and quality of life outcomes.

• #17 Current Diagnosis and Management of Multiple Myeloma

  https://www.cancernetwork.com/view/current-diagnosis-and-management-multiple-myeloma

  Nurses have a unique opportunity and challenge to assimilate knowledge about these therapies, disease manifestations, and individual patient comorbidities to collaboratively develop a comprehensive patient care plan with the healthcare team. […] Skeletal involvement affects nearly 70% of myeloma patients during the course of their disease. […] All patients with documented bone disease should be given a bisphosphonate (pamidronate [Aredia] or zoledronic acid [Zometa]) monthly. […] Because the osteopenia and lytic lesions place the patient at high risk for fractures, it is crucial that oncology nurses know the number and sites of lytic lesions, to determine whether a patient is at risk for spontaneous pathologic fracture. […] Maintaining and improving physical functioning should be part of the patients treatment plan.

• #18 Current Diagnosis and Management of Multiple Myeloma

  https://www.cancernetwork.com/view/current-diagnosis-and-management-multiple-myeloma

  At every encounter, nurses should evaluate myeloma patients abilities to perform activities of daily living in a safe manner, so that falls and fractures are avoided. […] Nurses are in a unique position to assess and explore pain in a stepwise and ongoing fashion, using verbal and nonverbal pain scales and grading systems. […] Nursing care goals are to maintain or improve kidney function. […] Nurses can help to guide the myeloma patient and family through this long journey. […] Understanding the disease and its treatments allows the practitioner to ask pointed questions as part of the assessment. […] Advocating quality of life for patients includes patient education and support and coaching them to be self-advocates. […] Through exceptional care, oncology nurses can advocate for the patient with multiple myeloma to optimize treatment and quality of life outcomes.

• #19 Nursing care plan for multiple myeloma

  https://nursipedia.com/nursing-care-plan-multiple-myeloma/

  Nursing care plan for multiple myeloma is important to address the symptoms of multiple myeloma and prevent any potential complications. […] When assessing a patient with multiple myeloma, a nurse should check for signs and symptoms, including fatigue, anemia, bone pain and fracture, hypercalcemia, kidney failure, and neurological issues. […] The most common nursing diagnosis associated with multiple myeloma is risk of infection. […] The goals of nursing management in patients with multiple myeloma involve maintaining/improving quality of life, ensuring adequate nutrition and hydration, preventing complications, optimizing treatment outcomes, and providing psychological and emotional support. […] The primary interventions for multiple myeloma include treatment with chemotherapy and/or targeted therapy and supportive care.

• #20 Multiple Myeloma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/multiple-myeloma/?srsltid=AfmBOopQ6SLqme9rXL8gPr9HzyGy8v4A-uRh1LF-keEC5PDdxZVH70-J

  Multiple myeloma is a malignancy of the plasma cells that develops in the bone marrow. […] General management includes the following: Administration of medications to maintain patients comfort. […] Assessment of body systems that may be affected by diagnosis (renal, skeletal, circulatory). […] Refer patient to oncologist, radiation oncologist. […] Watchful waiting for newly diagnosed with indolent disease. […] Monitor the condition in the early stages without treatment (asymptomatic). […] Transplant eligibility for those with symptomatic disease based on comorbidities and performance status. […] Encourage activities to maintain strength. […] Well balanced nutrition with increased caloric intake during treatment of with patients losing weight from disease process. […] Increase fluid intake to avoid renal complications.

• #21 Multiple Myeloma, Cancer, Information, Resources

  https://www.cancercare.org/diagnosis/multiple_myeloma

  CancerCare provides free, professional support services for people affected by multiple myeloma, as well as multiple myeloma treatment information and additional resources. […] Oncology social workers help you cope with the emotional and practical challenges of multiple myeloma. […] CancerCare offers specialized programs to address specific populations and concerns. […] Coping with a new diagnosis can also be emotionally challenging for both the patient and loved ones. CancerCare offers a number of free support services including individual counseling and telephone and online support groups for anyone that has been affected by cancer. […] Many patients do experience changes in weight, including weight loss. These changes are common and can be caused by a number of factors including poor appetite, fatigue or treatment side effects. […] Bone pain is another common side effect of multiple myeloma. […] More information on pain can be found in our publication Managing Cancer Pain. View all of CancerCare’s pain-related resources.

• #22

  https://journals.lww.com/nursingmadeincrediblyeasy/fulltext/2015/01000/understanding_multiple_myeloma.8.aspx

  GENERAL PURPOSE: To provide information about multiple myeloma. […] Identify the medical and nursing techniques for managing multiple myeloma. […] One chemotherapy drug commonly used to treat multiple myeloma is melphalan. […] Aggressive pain management in multiple myeloma is accomplished by extended-release opioids given in combination with anti-inflammatory medications. […] Teach patients with multiple myeloma to prevent infection by doing all the following except avoiding contact with family pets.

• #23 Multiple Myeloma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0315/p373.html

  Patients with multiple myeloma are at high risk of serious infections; prompt recognition and treatment are critical. Prophylactic antibiotics are recommended in certain situations; this includes use of trimethoprim/sulfamethoxazole or a fluoroquinolone for the first three months of treatment. Prophylactic penicillin is prescribed only for recurrent pneumococcal infections; intravenous immune globulin is given for recurrent serious bacterial infections. Prophylactic antiviral treatment is recommended for patients taking proteasome inhibitors because of the risk of varicella-zoster virus reactivation. […] Family physicians should have a high index of suspicion for multiple myeloma because presenting symptoms are often nonspecific. Patients with plasma cell disorders should be monitored for complications such as the development of bone pain, peripheral neuropathy, infections, thromboembolism, weight loss, fatigue, and treatment toxicity such as cytopenias and gastrointestinal symptoms. Addressing nutritional issues and pain control is an important concern. Pain management is multimodal with use of analgesic and neuropathic medications, radiation therapy, and psychological support.

• #24 Supportive care for multiple myeloma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/multiple-myeloma/supportive-care

  Supportive care helps people meet the physical, practical, emotional and spiritual challenges of multiple myeloma. It is an important part of cancer care. […] Recovering from multiple myeloma and adjusting to life after treatment is different for each person, depending on the extent of the disease, the type of treatment and many other factors. […] Preventing infection is important for people with multiple myeloma. Having good hygiene, protecting your skin and maintaining good general health are some ways to help prevent infection. […] Bone pain is a common symptom in people with multiple myeloma. […] Treatments for bone pain and fractures may include radiation therapy, bisphosphonates, and pain medicines. […] Emotional health is a significant aspect of care for individuals with multiple myeloma. […] Making some changes to your lifestyle and developing a wellness plan can help you to better cope with having multiple myeloma.

• #25 Current Diagnosis and Management of Multiple Myeloma

  https://www.cancernetwork.com/view/current-diagnosis-and-management-multiple-myeloma

  Nurses have a unique opportunity and challenge to assimilate knowledge about these therapies, disease manifestations, and individual patient comorbidities to collaboratively develop a comprehensive patient care plan with the healthcare team. […] Skeletal involvement affects nearly 70% of myeloma patients during the course of their disease. […] All patients with documented bone disease should be given a bisphosphonate (pamidronate [Aredia] or zoledronic acid [Zometa]) monthly. […] Because the osteopenia and lytic lesions place the patient at high risk for fractures, it is crucial that oncology nurses know the number and sites of lytic lesions, to determine whether a patient is at risk for spontaneous pathologic fracture. […] Maintaining and improving physical functioning should be part of the patients treatment plan.

• #26 Supportive care for multiple myeloma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/multiple-myeloma/supportive-care

  Supportive care helps people meet the physical, practical, emotional and spiritual challenges of multiple myeloma. It is an important part of cancer care. […] Recovering from multiple myeloma and adjusting to life after treatment is different for each person, depending on the extent of the disease, the type of treatment and many other factors. […] Preventing infection is important for people with multiple myeloma. Having good hygiene, protecting your skin and maintaining good general health are some ways to help prevent infection. […] Bone pain is a common symptom in people with multiple myeloma. […] Treatments for bone pain and fractures may include radiation therapy, bisphosphonates, and pain medicines. […] Emotional health is a significant aspect of care for individuals with multiple myeloma. […] Making some changes to your lifestyle and developing a wellness plan can help you to better cope with having multiple myeloma.

• #27 Current Diagnosis and Management of Multiple Myeloma

  https://www.cancernetwork.com/view/current-diagnosis-and-management-multiple-myeloma

  At every encounter, nurses should evaluate myeloma patients abilities to perform activities of daily living in a safe manner, so that falls and fractures are avoided. […] Nurses are in a unique position to assess and explore pain in a stepwise and ongoing fashion, using verbal and nonverbal pain scales and grading systems. […] Nursing care goals are to maintain or improve kidney function. […] Nurses can help to guide the myeloma patient and family through this long journey. […] Understanding the disease and its treatments allows the practitioner to ask pointed questions as part of the assessment. […] Advocating quality of life for patients includes patient education and support and coaching them to be self-advocates. […] Through exceptional care, oncology nurses can advocate for the patient with multiple myeloma to optimize treatment and quality of life outcomes.

• #28 Multiple Myeloma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/multiple-myeloma/?srsltid=AfmBOopQ6SLqme9rXL8gPr9HzyGy8v4A-uRh1LF-keEC5PDdxZVH70-J

  Multiple myeloma is a malignancy of the plasma cells that develops in the bone marrow. […] General management includes the following: Administration of medications to maintain patients comfort. […] Assessment of body systems that may be affected by diagnosis (renal, skeletal, circulatory). […] Refer patient to oncologist, radiation oncologist. […] Watchful waiting for newly diagnosed with indolent disease. […] Monitor the condition in the early stages without treatment (asymptomatic). […] Transplant eligibility for those with symptomatic disease based on comorbidities and performance status. […] Encourage activities to maintain strength. […] Well balanced nutrition with increased caloric intake during treatment of with patients losing weight from disease process. […] Increase fluid intake to avoid renal complications.

• #29 Multiple Myeloma | Supportive Care for Multiple Myeloma | LLS

  https://www.lls.org/myeloma/treatment/supportive-care-and-disease-complications

  Supportive (palliative) care for myeloma helps manage the complications of the disease and the adverse side effects of the drugs used for treatment, including: […] Myeloma patients may have serious problems with their kidney function. Timely, adequate treatment of myeloma can improve kidney function and, potentially, even return it to normal in most cases. […] This is the term for damage to nerves of the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body and from the body back to the brain. […] Patients who receive myeloma treatments that are associated with DVT risk are usually prescribed medication to reduce the likelihood of developing this condition. […] Hyperviscosity syndrome is considered a medical emergency and requires urgent treatment with plasmapheresis and exchange, a procedure that rapidly reduces the concentration of monoclonal proteins in the blood.

• #30 Multiple Myeloma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/multiple-myeloma/?srsltid=AfmBOopQ6SLqme9rXL8gPr9HzyGy8v4A-uRh1LF-keEC5PDdxZVH70-J

  Offer patient frequent, smaller meals with increased amount of fluid daily. […] Offer information about support groups for patient and family. […] Implement protocols to avoid risk for injury related to falls and thrombotic events. […] Educate about risk of infection and need for vaccination if recommended. […] Educate about importance of avoiding nephrotoxic medications (e.g., NSAIDs). […] Educate patient about disease process and treatment plan. […] Importance of follow up care monitoring especially for those diagnosed asymptomatically. […] Importance of follow up care and biopsies to indicate progression of disease of remission status. […] Importance of following medication therapy as instructed.

• #31 Self-Care for Multiple Myeloma

  https://www.webmd.com/cancer/multiple-myeloma/multiple-myeloma-self-care

  Nutrition is a big part of multiple myeloma self-care. Eat a well-balanced diet during and after treatment to help improve the way you feel, better your strength, and speed up your recovery. […] Before you start any physical activity, talk to your doctor. With multiple myeloma, you might be at risk of mobility issues, falls, or fractures. Your doctor will be able to assess you regularly to see what kind of exercise you can do and what you should avoid. […] Stress can be very harmful for people with multiple myeloma. This is a type of cancer that can damage your bone marrow and the cells it produces. Your bone marrow normally helps your immune system work by making antibody-producing cells. Stress makes things more complicated because it greatly disrupts your immune system. […] It’s important to talk to your doctor about fatigue. They can adjust your medication, tweak your diet, enhance your electrolyte and fluid intake, or help you find a medication to help with feeling sleepy or fatigued.

• #32 Conceptualizing an Integrative Multiple Myeloma Care: The Role of Nutrition, Supplements, and Complementary Modalities

  https://www.mdpi.com/2072-6643/16/2/237

  Another important risk factor to consider at diagnosis is the nutritional status of the patient, especially the presence of sarcopenia, which is a negative prognostic factor. […] Sarcopenia is frequent in patients with MM at diagnosis; the presence of reduced subcutaneous adipose tissue is associated with a worse prognosis. […] The risk of muscle mass deficiency must never be neglected, and an adequate protein intake must be guaranteed to the patient at diagnosis and throughout the treatment, which can itself contribute to sarcopenia. […] A daily protein intake of at least 1.4 g/kg appears to be necessary to obtain or maintain adequate muscle mass according to a recent systematic review. […] The microbiota is also inevitably involved in the link between nutrition and MM mentioned above, being the first mediator of the effect of food on the body.

• #33 Opportunities for Improving the Care of Patients with Multiple Myeloma – Conquer: the journey informed

  https://conquer-magazine.com/issues/special-issues/conquering-the-multiple-myeloma-continuum-series-one/opportunities-for-improving-the-care-of-patients-with-multiple-myeloma

  The group also lamented the lack of survivorship care programs to help patients maintain continuity of care and address survivorship issues with life course implications. […] The group conveyed that it is often difficult for patients to decide whether the side effects are related to the treatment or to the disease. […] The group stressed that it was important to educate patients about drug-drug interactions and drug-food interactions, particularly regarding oral drugs. […] The group stated that patients had little knowledge of drug manufacturer-provided tools and resources for multiple myeloma. […] The group expressed their interest in ASCOs CancerLinQ, a database that collects treatment information from actual patients with cancer that helps oncologists make treatment decisions for their patients. […] This article highlights the key challenges and unmet needs of patients with multiple myeloma, and their unique recommendations to remedy these shortcomings.

• #34 Multiple Myeloma Treatments | Drugs & Treatment by Stage

  https://themmrf.org/diagnosis-and-treatment/treatment-options/

  As a multiple myeloma patient, it’s important to start the right treatment plan quickly to increase your chances of achieving your best outcome. […] There is no cure for multiple myeloma; however, there are many treatment options (with new ones emerging every year) to effectively manage the disease. […] You and your doctor will determine a treatment plan designed for you and the specifics of your multiple myeloma diagnosis. […] When you are first diagnosed with multiple myeloma, the goal of treatment is to provide symptom relief and reduce the amount of myeloma cells in your body as quickly and safely as possible. […] The standard of care for newly diagnosed multiple myeloma is called induction therapy, followed by an autologous stem cell transplant (if eligible) and maintenance therapy; collectively, these are considered one line of therapy.

• #35 Multiple Myeloma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/multiple-myeloma/?srsltid=AfmBOopQ6SLqme9rXL8gPr9HzyGy8v4A-uRh1LF-keEC5PDdxZVH70-J

  The following medications might be used for the treatment of MM: Corticosteroids. […] Induction chemotherapy for transplant eligible patients. […] Induction therapy for transplant ineligible individuals includes a monoclonal antibody, daratumumab (Darzalex) in addition to the induction therapy for transplant eligible patients. […] Management of myeloma bone disease. […] Use the nursing process to develop a plan of care for individuals. […] The nursing assessment (with common findings listed), diagnosis, interventions, expected outcomes, and education for individuals with MM are listed below. […] Monitor CBC for elevated WBCs, chemistry panels for electrolyte imbalances and renal function. […] Administration of prescribed medications. […] Encourage patient to verbalize feelings about illness.

• #36

  https://www.nhs.uk/conditions/multiple-myeloma/treatment/

  Corticosteroids help destroy myeloma cells and make chemotherapy more effective. […] The most common types used to treat myeloma are dexamethasone and prednisolone. […] Thalidomide can help kill myeloma cells. […] Bortezomib can help kill myeloma cells by causing protein to build up inside them. […] Daratumumab helps kill the cancerous myeloma cells. […] People receiving intensive treatment are given a much higher dose of chemotherapy medicine as an inpatient to help destroy a larger number of myeloma cells. […] Further treatment is needed if myeloma returns. […] Treatment for relapses is similar to initial treatment, although non-intensive treatment is often preferred. […] Lenalidomide and pomalidomide are similar to thalidomide. […] They may also increase your risk of developing a blood clot and have other side effects similar to thalidomide.

• #37 Nursing Considerations for Select Multiple Myeloma Treatments

  https://conference-correspondent.com/highlights/ons/ons-2023-multiple-myeloma-wrap-up/nursing-considerations-for-select-multiple-myeloma-treatments

  There are several considerations and clinical pearls for nurses to understand when treating patients with multiple myeloma with multidrug regimens. […] Dosing and other considerations were discussed for certain treatments in the session New and Emerging Therapies in Multiple Myeloma: Case Studies for Nurses. […] Monitor blood counts, response, signs of infection. […] Counsel on oral adherence. […] Risk Evaluation and Mitigation Strategies (REMS) for refills. […] Infection prophylaxis (acyclovir, Bactrim, IV immunoglobulin if 400 mg/dL). […] Cytokine release syndrome and neurotoxicity management.

• #38 Nursing Considerations for Select Multiple Myeloma Treatments

  https://conference-correspondent.com/highlights/ons/ons-2023-multiple-myeloma-wrap-up/nursing-considerations-for-select-multiple-myeloma-treatments

  There are several considerations and clinical pearls for nurses to understand when treating patients with multiple myeloma with multidrug regimens. […] Dosing and other considerations were discussed for certain treatments in the session New and Emerging Therapies in Multiple Myeloma: Case Studies for Nurses. […] Monitor blood counts, response, signs of infection. […] Counsel on oral adherence. […] Risk Evaluation and Mitigation Strategies (REMS) for refills. […] Infection prophylaxis (acyclovir, Bactrim, IV immunoglobulin if 400 mg/dL). […] Cytokine release syndrome and neurotoxicity management.

• #39 Multiple Myeloma Treatments | Drugs & Treatment by Stage

  https://themmrf.org/diagnosis-and-treatment/treatment-options/

  As a multiple myeloma patient, it’s important to start the right treatment plan quickly to increase your chances of achieving your best outcome. […] There is no cure for multiple myeloma; however, there are many treatment options (with new ones emerging every year) to effectively manage the disease. […] You and your doctor will determine a treatment plan designed for you and the specifics of your multiple myeloma diagnosis. […] When you are first diagnosed with multiple myeloma, the goal of treatment is to provide symptom relief and reduce the amount of myeloma cells in your body as quickly and safely as possible. […] The standard of care for newly diagnosed multiple myeloma is called induction therapy, followed by an autologous stem cell transplant (if eligible) and maintenance therapy; collectively, these are considered one line of therapy.

• #40 Course Content – #30714: Multiple Myeloma – NetCE

  https://www.netce.com/coursecontent.php?courseid=2760

  For the many thousands of patients diagnosed with MM, the impetus to find newer and improved therapies continues. […] Without question, the last 30 years have seen major changes in treatment options, but the greatest strides in improving survival rates have been made since the late 1990s. […] Stem cell transplants, whether autologous or allogeneic, single or tandem, are available for eligible patients, generally up to 65 years of age (though this is not an absolute rule). […] The first universally accepted staging system for MM emerged in 1975 from Durie and Salmon. […] As noted, due to the nature of this disease, not every patient with MM requires treatment. […] The hallmarks of the disease—calcium elevation, renal insufficiency, anemia, and bone disease—are known by the acronym CRAB.

• #41 Multiple Myeloma | Diagnosis & Treatment | MedStar Health

  https://www.medstarhealth.org/services/multiple-myeloma

  You’ll benefit from seamless coordination with our renowned bone marrow transplant center. […] Home to the nations largest stem cell collection facility, our Stem Cell Transplant and Cellular Immunotherapy program is the regions only adult, Foundation for the Accreditation of Cellular Therapy (FACT)-accredited program for autologous transplant, allogeneic transplant, and cellular immunotherapy. Our transplant specialists have exceptional experience caring for eligible patients before, during, and after their transplant procedure. In addition, we have innovative technology and unmatched experience in using CAR-T cell therapy to treat other blood cancers, which we hope to translate as a treatment option for myeloma patients in the future. […] Even after entering remission, cancer survivors benefit from physical, emotional, and psychological support services that help them return to good health. From a myeloma support group to personalized rehabilitation and follow-up care, we’re here for you and your family. […] Multiple myeloma affects people in different ways, and physical or occupational therapy can help you to move and feel like yourself after treatment. Through a rehabilitation plan designed to meet your unique needs, our rehabilitation experts can help you rebuild strength, stamina, and flexibility.

• #42 Connecting Patients With Multiple Myeloma to Larger Institutions for CAR T-Cell Therapy

  https://www.oncnursingnews.com/view/connecting-patients-with-multiple-myeloma-to-larger-institutions-for-car-t-cell-therapy

  Oncology nurses at local and specialized centers can work together to create a pathway for patients throughout CAR T-cell therapy treatment. […] These new advances have also expanded the role of nurses, who are involved in the planning, assessment, administration, and posttreatment monitoring of patients receiving CAR T-cell therapy. […] A 2023 study found that collaboration between oncology nurses is critical as patients migrate between community oncology providers and specialized treatment centers. […] Because early referrals to a specialized CAR T-cell treatment program are critical to achieve the best outcomes, oncology nurses need to be aware of the eligibility criteria for CAR T-cell therapy. […] Local oncology nurses can also guide patients who would like to pursue a second opinion on their treatment options.

• #43 Connecting Patients With Multiple Myeloma to Larger Institutions for CAR T-Cell Therapy

  https://www.oncnursingnews.com/view/connecting-patients-with-multiple-myeloma-to-larger-institutions-for-car-t-cell-therapy

  With so many treatment advances, Faiman says its important for nurses to ensure patients with multiple myeloma get the best possible care. […] Because community oncology nurses are at the forefront of patient education, Faiman says the subject of second opinions and the possibility of CAR T-cell therapy can be easily broached. […] Faiman says patients who qualify for CAR T-cell therapy are required to have a care partner, such as a family member, friend, or member of their community. […] This is critical, as patients need to be monitored for about a month after receiving their treatment. […] Before receiving CAR T, Faiman says nurse coordinators will speak with a patients local nurse about when to stop treatment before they travel to a specialized center, what kind of immunizations patients should receive after treatment, and how patients should be monitored.

• #44 Nursing care of patients with relapsed and refractory multiple myeloma treated with B-cell mature antigen-targeted universal chimeric antigen receptor T cells

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10681383/

  To investigate the efficacy of a nursing approach using B-cell maturation antigen (BCMA)-targeted universal chimeric antigen receptor T-cell (BCMA-UCART) immunotherapy in the treatment of 16 patients with relapsed refractory multiple myeloma (MM). […] The main points of nursing care included timely assessment of organ functional status, safe and accurate infusion of BCMA-UCART, identification and management of hyperthermia, hypotension, arrhythmia and central nervous system adverse reactions caused by cytokine release after BCMA-UCART infusion, as well as management of fluid imbalance, maintenance of stable blood pressure, and cooperation with physicians to effectively control of inflammatory factors. […] The nursing program with BCMA-UCART immunotherapy is effective in intervening MM patients and promotes their early recovery and discharge from the hospital.

• #45 Nursing Considerations for Select Multiple Myeloma Treatments

  https://conference-correspondent.com/highlights/ons/ons-2023-multiple-myeloma-wrap-up/nursing-considerations-for-select-multiple-myeloma-treatments

  There are several considerations and clinical pearls for nurses to understand when treating patients with multiple myeloma with multidrug regimens. […] Dosing and other considerations were discussed for certain treatments in the session New and Emerging Therapies in Multiple Myeloma: Case Studies for Nurses. […] Monitor blood counts, response, signs of infection. […] Counsel on oral adherence. […] Risk Evaluation and Mitigation Strategies (REMS) for refills. […] Infection prophylaxis (acyclovir, Bactrim, IV immunoglobulin if 400 mg/dL). […] Cytokine release syndrome and neurotoxicity management.

• #46 Nursing care of patients with relapsed and refractory multiple myeloma treated with B-cell mature antigen-targeted universal chimeric antigen receptor T cells

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10681383/

  To investigate the efficacy of a nursing approach using B-cell maturation antigen (BCMA)-targeted universal chimeric antigen receptor T-cell (BCMA-UCART) immunotherapy in the treatment of 16 patients with relapsed refractory multiple myeloma (MM). […] The main points of nursing care included timely assessment of organ functional status, safe and accurate infusion of BCMA-UCART, identification and management of hyperthermia, hypotension, arrhythmia and central nervous system adverse reactions caused by cytokine release after BCMA-UCART infusion, as well as management of fluid imbalance, maintenance of stable blood pressure, and cooperation with physicians to effectively control of inflammatory factors. […] The nursing program with BCMA-UCART immunotherapy is effective in intervening MM patients and promotes their early recovery and discharge from the hospital.

• #47 Connecting Patients With Multiple Myeloma to Larger Institutions for CAR T-Cell Therapy

  https://www.oncnursingnews.com/view/connecting-patients-with-multiple-myeloma-to-larger-institutions-for-car-t-cell-therapy

  After receiving CAR T-cell therapy, patients must remain close to the specialized center of care for at least 4 weeks to be checked for low blood counts and possible infections. […] After patients with multiple myeloma return home after CAR T-cell treatment, Baer says the specialized center and their local oncologist will continue to monitor them. […] Oncology nurses are taught to look for adverse effects such as cytokine release syndrome, which is a common adverse effect that can include fever, fatigue, and nausea. […] We see patients after theyre 30 days [out of] our outpatient program, and then we see them every month until theyre 3 months out, she says. […] Studies have shown that when people receive CAR T-cell treatment earlier, they can have a longer remission and enjoy a good quality of life.

• #48 Current Diagnosis and Management of Multiple Myeloma

  https://www.cancernetwork.com/view/current-diagnosis-and-management-multiple-myeloma

  Nurses have a unique opportunity and challenge to assimilate knowledge about these therapies, disease manifestations, and individual patient comorbidities to collaboratively develop a comprehensive patient care plan with the healthcare team. […] Skeletal involvement affects nearly 70% of myeloma patients during the course of their disease. […] All patients with documented bone disease should be given a bisphosphonate (pamidronate [Aredia] or zoledronic acid [Zometa]) monthly. […] Because the osteopenia and lytic lesions place the patient at high risk for fractures, it is crucial that oncology nurses know the number and sites of lytic lesions, to determine whether a patient is at risk for spontaneous pathologic fracture. […] Maintaining and improving physical functioning should be part of the patients treatment plan.

• #49 Multiple Myeloma: Symptoms, Treatment and Diagnosis | Ochsner Health

  https://www.ochsner.org/services/multiple-myeloma

  At Ochsner, we provide comprehensive diagnosis and treatment for patients with multiple myeloma. […] Ochsner offers multiple myeloma treatments including stem cell transplants and CAR T cell therapy. […] Patients with multiple myeloma may receive a stem cell transplant or CAR T Cell Therapy. […] Ochsner provides multidisciplinary care for multiple myeloma treatment. This means our dedicated cancer care professionals from multiple teams work together to deliver the most effective treatment and support available. […] The Ochsner multidisciplinary myeloma care team includes: Blood bank and cellular processing physicians, Dietitians, Hematologists, Nurse practitioners, Nurses, Pathologists, Pharmacist, Physician assistants, Psychologists, Radiologists, Social workers. […] Ochsner is one of the busiest myeloma centers in Louisiana.

• #50 Understanding and managing myeloma | Nursing Times

  https://www.nursingtimes.net/cancer/understanding-and-managing-myeloma-21-08-2014/

  Non-specialist nurses need to know how to care for patients with myeloma. […] Myeloma treatment includes: multi-drug chemotherapy regimens, which work synergistically; supportive treatments, such as bisphosphonates to protect against bone damage; and prevention and management of infection. Therefore, treatment plans are complex and present challenges to nurses and other health professionals caring for patients with myeloma. […] It is important to establish contacts with specialist colleagues, who can advise on patients specific myeloma-related needs. Specialists can also offer advice and guidance on the warning signs of myeloma-related complications or on signs that the disease is progressing. […] All patients with myeloma require supportive care. This is of critical importance in improving survival and quality of life for this group. Nurses play a vital role in patient education and in the early recognition of complications, such as infections or thrombosis, which need emergency treatment.

• #51 Supportive care for multiple myeloma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/multiple-myeloma/supportive-care

  Supportive care helps people meet the physical, practical, emotional and spiritual challenges of multiple myeloma. It is an important part of cancer care. […] Recovering from multiple myeloma and adjusting to life after treatment is different for each person, depending on the extent of the disease, the type of treatment and many other factors. […] Preventing infection is important for people with multiple myeloma. Having good hygiene, protecting your skin and maintaining good general health are some ways to help prevent infection. […] Bone pain is a common symptom in people with multiple myeloma. […] Treatments for bone pain and fractures may include radiation therapy, bisphosphonates, and pain medicines. […] Emotional health is a significant aspect of care for individuals with multiple myeloma. […] Making some changes to your lifestyle and developing a wellness plan can help you to better cope with having multiple myeloma.

• #52 Living as a Multiple Myeloma Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/multiple-myeloma/after-treatment/follow-up.html

  Some amount of feeling depressed, anxious, or worried is normal when multiple myeloma is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others.

• #53 Palliative Care and Multiple Myeloma | Get Palliative Care

  https://getpalliativecare.org/whatis/disease-types/multiple-myeloma-palliative-care/

  Multiple myeloma is a blood cancer. […] Palliative care is specialized medical care for people with serious illness. It focuses on providing you with relief from the symptoms, pain and stress of a serious illness like multiple myeloma. […] Palliative care specialists have expertise in treating the symptoms of multiple myeloma. They help you to understand complex medical information and match your treatment choices to your personal needs and goals. […] The symptoms and side effects of multiple myeloma can make life harder for you and your family. […] If you or a loved one is facing multiple myeloma, ask your doctor for a referral to palliative care.

• #54 Supportive care for multiple myeloma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/multiple-myeloma/supportive-care

  Supportive care helps people meet the physical, practical, emotional and spiritual challenges of multiple myeloma. It is an important part of cancer care. […] Recovering from multiple myeloma and adjusting to life after treatment is different for each person, depending on the extent of the disease, the type of treatment and many other factors. […] Preventing infection is important for people with multiple myeloma. Having good hygiene, protecting your skin and maintaining good general health are some ways to help prevent infection. […] Bone pain is a common symptom in people with multiple myeloma. […] Treatments for bone pain and fractures may include radiation therapy, bisphosphonates, and pain medicines. […] Emotional health is a significant aspect of care for individuals with multiple myeloma. […] Making some changes to your lifestyle and developing a wellness plan can help you to better cope with having multiple myeloma.

• #55 Multiple Myeloma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/multiple-myeloma/?srsltid=AfmBOopQ6SLqme9rXL8gPr9HzyGy8v4A-uRh1LF-keEC5PDdxZVH70-J

  Offer patient frequent, smaller meals with increased amount of fluid daily. […] Offer information about support groups for patient and family. […] Implement protocols to avoid risk for injury related to falls and thrombotic events. […] Educate about risk of infection and need for vaccination if recommended. […] Educate about importance of avoiding nephrotoxic medications (e.g., NSAIDs). […] Educate patient about disease process and treatment plan. […] Importance of follow up care monitoring especially for those diagnosed asymptomatically. […] Importance of follow up care and biopsies to indicate progression of disease of remission status. […] Importance of following medication therapy as instructed.

• #56 Nursing care plan for multiple myeloma

  https://nursipedia.com/nursing-care-plan-multiple-myeloma/

  Nursing care plan for multiple myeloma is important to address the symptoms of multiple myeloma and prevent any potential complications. […] When assessing a patient with multiple myeloma, a nurse should check for signs and symptoms, including fatigue, anemia, bone pain and fracture, hypercalcemia, kidney failure, and neurological issues. […] The most common nursing diagnosis associated with multiple myeloma is risk of infection. […] The goals of nursing management in patients with multiple myeloma involve maintaining/improving quality of life, ensuring adequate nutrition and hydration, preventing complications, optimizing treatment outcomes, and providing psychological and emotional support. […] The primary interventions for multiple myeloma include treatment with chemotherapy and/or targeted therapy and supportive care.

• #57 Multiple Myeloma: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.multiple-myeloma-care-instructions.uh3308

  Multiple myeloma is cancer in plasma cells, which are a type of white blood cell. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. […] Tell your doctor if you are experiencing new pain, or pain that interferes with your daily activities. Do not try to „tough it out.” […] Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. […] Get enough sleep, and take time to do things you enjoy. This can help reduce stress. […] If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself. […] Watch closely for changes in your health, and be sure to contact your doctor if you have any symptoms that the cancer has come back or spread.

• #58

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3308

  Multiple myeloma is cancer in plasma cells, which are a type of white blood cell. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. […] Tell your doctor if you are experiencing new pain, or pain that interferes with your daily activities. Do not try to „tough it out.” […] Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. […] If you have not already done so, prepare an advance care plan. An advance care plan provides instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any symptoms that the cancer has come back or spread.

• #59 Care Plan to Track Multiple Myeloma Progression | That’s My Word™

  https://www.thatsmywordmm.com/care-plan-to-track-progression/

  Being open and transparent with your care team makes it easier to find solutions that are best suited for you. […] If we have risk factors or symptoms, going to our doctor for our annual blood work and looking for increased calcium levels, increased protein levels, or anemia is the first step to staying healthy and catching MM early. […] Regardless of the type of doctor you see, you should let them know about your healthcare goals and create a plan that can help you accomplish them. […] Keeping a record of what happens in between your doctors’ appointments can be a lot easier than trying to remember everything the next time you visit. […] When you leave the doctors office, its always a good idea to schedule your next appointment in advance. […] Another part of advocating for yourself is having a conversation with your provider and being a part of that discussion about what treatment options will work best for you and your lifestyle.

• #60 Hospice Care for Multiple Myeloma: What to Know

  https://www.webmd.com/cancer/multiple-myeloma/hospice-care-multiple-myeloma

  Hospice care is a form of compassionate care that focuses on quality of life rather than length of life and treatment, for someone who has an incurable disease. The goal is to allow you to live as fully and comfortably as possible. […] When you enter hospice care, you’ll work with a medical team to manage your symptoms so that you can live with dignity and quality. The focus is also family-centered. Both you and your loved ones will make the decisions. […] Hospice care is recommended when the multiple myeloma advances to a point that treatment can no longer control it. In general, hospice is usually considered when: You have less than 6 months to live. […] Once you’ve entered hospice, you can stop at any time and return to active multiple myeloma treatment. If you don’t want to do that, hospice allows you to make the best use of your last days with an advanced illness.

• #61 Hospice Care for Multiple Myeloma: What to Know

  https://www.webmd.com/cancer/multiple-myeloma/hospice-care-multiple-myeloma

  The first step is to talk to your doctor. They will start the referral to hospice care. They will certify that your life expectancy is under 6 months if the multiple myeloma is allowed to run its typical course. […] Hospice can be done wherever you are. Most of the time, that’s at your home or your assisted living center or nursing home. […] If you or your loved one is over the age of 65, you’ll be covered through Medicare as long as you use a Medicare-certified provider, which covers all aspects of hospice care. […] You won’t receive any more medications to treat your multiple myeloma. You usually won’t receive dialysis for kidney disease or blood transfusions for anemia, both of which are common if you have multiple myeloma. Instead, you’ll receive medications for general pain relief. Other services include: Medical equipment like a hospital bed, wheelchairs, or walkers, as well as medical supplies like oxygen. […] Grief and loss counseling for you and your loved ones. These are also provided to families for about a year after the patient’s death.

• #62 Effects of comprehensive care in patients with multiple myeloma with cardiac dysfunction

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8205761/

  Objective: To explore the effect of comprehensive care on cardiac and renal function indices, treatment compliance, self-care ability and quality of life in patients with multiple myeloma combined with cardiac dysfunction. […] Comprehensive care can significantly help to improve cardiac and renal functions, treatment compliance, self-care ability and quality of life in patients with multiple myeloma combined with cardiac dysfunction, which is of great clinical significance. […] Comprehensive care is a modern nursing model based on the concept of holistic nursing, which emphasizes the comprehensiveness and integrality of nursing measurements. Patients with MM have a long time of treatment and rehabilitation, so it is necessary to provide them with more professional and efficient comprehensive care so as to improve their quality of life.

• #63 Effects of comprehensive care in patients with multiple myeloma with cardiac dysfunction

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8205761/

  Providing good care for patients from the beginning of diagnosis to treatment can help patients with MM maintain good health and improve their quality of life. […] Therefore, the key task of care for patients with MM is to encourage them to face life positively and improve negative emotions, treatment compliance, self-care ability, and the quality of life through personalized and comprehensive care. […] This study introduced comprehensive care for patients with MM combined with cardiac dysfunction. Health education was provided to patients by professional nursing team, so that patients could better understand the condition and increase confidence. […] The results revealed that comprehensive care for patients with MM with cardiac dysfunction was helpful to improve cardiac and renal function, treatment compliance, self-care ability, and quality of life.

• #64 Nursing care plan for multiple myeloma

  https://nursipedia.com/nursing-care-plan-multiple-myeloma/

  Nursing care plan for multiple myeloma is important to address the symptoms of multiple myeloma and prevent any potential complications. […] When assessing a patient with multiple myeloma, a nurse should check for signs and symptoms, including fatigue, anemia, bone pain and fracture, hypercalcemia, kidney failure, and neurological issues. […] The most common nursing diagnosis associated with multiple myeloma is risk of infection. […] The goals of nursing management in patients with multiple myeloma involve maintaining/improving quality of life, ensuring adequate nutrition and hydration, preventing complications, optimizing treatment outcomes, and providing psychological and emotional support. […] The primary interventions for multiple myeloma include treatment with chemotherapy and/or targeted therapy and supportive care.

• #65 Multiple Myeloma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/multiple-myeloma/?srsltid=AfmBOopQ6SLqme9rXL8gPr9HzyGy8v4A-uRh1LF-keEC5PDdxZVH70-J

  Multiple myeloma is a malignancy of the plasma cells that develops in the bone marrow. […] General management includes the following: Administration of medications to maintain patients comfort. […] Assessment of body systems that may be affected by diagnosis (renal, skeletal, circulatory). […] Refer patient to oncologist, radiation oncologist. […] Watchful waiting for newly diagnosed with indolent disease. […] Monitor the condition in the early stages without treatment (asymptomatic). […] Transplant eligibility for those with symptomatic disease based on comorbidities and performance status. […] Encourage activities to maintain strength. […] Well balanced nutrition with increased caloric intake during treatment of with patients losing weight from disease process. […] Increase fluid intake to avoid renal complications.

• #66 Nursing care plan for multiple myeloma

  https://nursipedia.com/nursing-care-plan-multiple-myeloma/

  Nursing care plan for multiple myeloma is important to address the symptoms of multiple myeloma and prevent any potential complications. […] When assessing a patient with multiple myeloma, a nurse should check for signs and symptoms, including fatigue, anemia, bone pain and fracture, hypercalcemia, kidney failure, and neurological issues. […] The most common nursing diagnosis associated with multiple myeloma is risk of infection. […] The goals of nursing management in patients with multiple myeloma involve maintaining/improving quality of life, ensuring adequate nutrition and hydration, preventing complications, optimizing treatment outcomes, and providing psychological and emotional support. […] The primary interventions for multiple myeloma include treatment with chemotherapy and/or targeted therapy and supportive care.

• #67 Multiple Myeloma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/multiple-myeloma/?srsltid=AfmBOopQ6SLqme9rXL8gPr9HzyGy8v4A-uRh1LF-keEC5PDdxZVH70-J

  Multiple myeloma is a malignancy of the plasma cells that develops in the bone marrow. […] General management includes the following: Administration of medications to maintain patients comfort. […] Assessment of body systems that may be affected by diagnosis (renal, skeletal, circulatory). […] Refer patient to oncologist, radiation oncologist. […] Watchful waiting for newly diagnosed with indolent disease. […] Monitor the condition in the early stages without treatment (asymptomatic). […] Transplant eligibility for those with symptomatic disease based on comorbidities and performance status. […] Encourage activities to maintain strength. […] Well balanced nutrition with increased caloric intake during treatment of with patients losing weight from disease process. […] Increase fluid intake to avoid renal complications.

• #68 Effects of comprehensive care in patients with multiple myeloma with cardiac dysfunction

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8205761/

  In conclusion, comprehensive care is worthy of clinical application. Instead of routine nursing care, the innovation of this study was to introduce comprehensive care model into the nursing work of patients with MM combined with cardiac dysfunction, which emphasized on patients medication, physical, mental and psychological status throughout whole process, so as to avoid careless omission that may lead to patients loss of confidence in treatment and affect the treatment effect.

• #69 Nursing care plan for multiple myeloma

  https://nursipedia.com/nursing-care-plan-multiple-myeloma/

  Nursing care plan for multiple myeloma is important to address the symptoms of multiple myeloma and prevent any potential complications. […] When assessing a patient with multiple myeloma, a nurse should check for signs and symptoms, including fatigue, anemia, bone pain and fracture, hypercalcemia, kidney failure, and neurological issues. […] The most common nursing diagnosis associated with multiple myeloma is risk of infection. […] The goals of nursing management in patients with multiple myeloma involve maintaining/improving quality of life, ensuring adequate nutrition and hydration, preventing complications, optimizing treatment outcomes, and providing psychological and emotional support. […] The primary interventions for multiple myeloma include treatment with chemotherapy and/or targeted therapy and supportive care.

• #70 Effects of comprehensive care in patients with multiple myeloma with cardiac dysfunction

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8205761/

  Providing good care for patients from the beginning of diagnosis to treatment can help patients with MM maintain good health and improve their quality of life. […] Therefore, the key task of care for patients with MM is to encourage them to face life positively and improve negative emotions, treatment compliance, self-care ability, and the quality of life through personalized and comprehensive care. […] This study introduced comprehensive care for patients with MM combined with cardiac dysfunction. Health education was provided to patients by professional nursing team, so that patients could better understand the condition and increase confidence. […] The results revealed that comprehensive care for patients with MM with cardiac dysfunction was helpful to improve cardiac and renal function, treatment compliance, self-care ability, and quality of life.

• #71 Current Diagnosis and Management of Multiple Myeloma

  https://www.cancernetwork.com/view/current-diagnosis-and-management-multiple-myeloma

  At every encounter, nurses should evaluate myeloma patients abilities to perform activities of daily living in a safe manner, so that falls and fractures are avoided. […] Nurses are in a unique position to assess and explore pain in a stepwise and ongoing fashion, using verbal and nonverbal pain scales and grading systems. […] Nursing care goals are to maintain or improve kidney function. […] Nurses can help to guide the myeloma patient and family through this long journey. […] Understanding the disease and its treatments allows the practitioner to ask pointed questions as part of the assessment. […] Advocating quality of life for patients includes patient education and support and coaching them to be self-advocates. […] Through exceptional care, oncology nurses can advocate for the patient with multiple myeloma to optimize treatment and quality of life outcomes.

• #72 Effects of comprehensive care in patients with multiple myeloma with cardiac dysfunction

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8205761/

  Providing good care for patients from the beginning of diagnosis to treatment can help patients with MM maintain good health and improve their quality of life. […] Therefore, the key task of care for patients with MM is to encourage them to face life positively and improve negative emotions, treatment compliance, self-care ability, and the quality of life through personalized and comprehensive care. […] This study introduced comprehensive care for patients with MM combined with cardiac dysfunction. Health education was provided to patients by professional nursing team, so that patients could better understand the condition and increase confidence. […] The results revealed that comprehensive care for patients with MM with cardiac dysfunction was helpful to improve cardiac and renal function, treatment compliance, self-care ability, and quality of life.

• #73 Nursing care plan for multiple myeloma

  https://nursipedia.com/nursing-care-plan-multiple-myeloma/

  Nursing care plan for multiple myeloma is important to address the symptoms of multiple myeloma and prevent any potential complications. […] When assessing a patient with multiple myeloma, a nurse should check for signs and symptoms, including fatigue, anemia, bone pain and fracture, hypercalcemia, kidney failure, and neurological issues. […] The most common nursing diagnosis associated with multiple myeloma is risk of infection. […] The goals of nursing management in patients with multiple myeloma involve maintaining/improving quality of life, ensuring adequate nutrition and hydration, preventing complications, optimizing treatment outcomes, and providing psychological and emotional support. […] The primary interventions for multiple myeloma include treatment with chemotherapy and/or targeted therapy and supportive care.

• #74 Multiple Myeloma | Fred Hutchinson Cancer Center

  https://www.fredhutch.org/en/diseases/multiple-myeloma.html

  Along with treating your cancer, a group of world-class professionals is here to support you. This team includes nurses, nurse practitioners, physician assistants, dietitians, physical therapists, social workers and psychologists. […] At Fred Hutch, caregivers are valuable members of a patients care team. […] Part of our mission is to help you take care of yourself. Caring for yourself is good for your own physical, mental and emotional health. […] Clinical trials pave the way for important advances in cancer treatment, and at Fred Hutch, we offer more active clinical trials than anywhere else. Patients with multiple myeloma may have the opportunity to join trials that are studying: Immunotherapies, CAR T-cell therapy, Experimental medicines, New combinations of medicines.

• #75 Disease and Symptom Care: A Focus on Specific Needs of Patients With Multiple Myeloma | Oncology Nursing Society

  https://www.ons.org/disease-and-symptom-care-focus-specific-needs-patients-multiple-myeloma

  Patients with multiple myeloma (MM) often deal with short- and long-term side effects of the treatment and disease sequelae. […] Guidelines for nursing management of side effects in patients with MM are absent or require updating. […] Nurses function in a range of capacities on the front lines of patient care and hold vital roles, such as coordinators and facilitators of care. […] Therefore, nurses are well positioned to identify, intervene in, and effectively manage disease- and treatment-related symptoms in patients with MM, improving MM treatment quality, treatment adherence, and patient QOL. […] Effective symptom management is a critical component of treatment adherence in MM. […] The IMF NLB aims to improve the care and self-care of patients with MM and to create new professional activities, such as this supplement, and address the unmet needs of patients and the nurses who care for them. […] It is the hope of the IMF NLB that these peer-reviewed, evidenced-based recommendations will be accepted as a standard of nursing care for patients to manage short- and long-term side effects and symptoms and improve QOL.

• #76 Multiple Myeloma | Supportive Care for Multiple Myeloma | LLS

  https://www.lls.org/myeloma/treatment/supportive-care-and-disease-complications

  Supportive (palliative) care for myeloma helps manage the complications of the disease and the adverse side effects of the drugs used for treatment, including: […] Myeloma patients may have serious problems with their kidney function. Timely, adequate treatment of myeloma can improve kidney function and, potentially, even return it to normal in most cases. […] This is the term for damage to nerves of the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body and from the body back to the brain. […] Patients who receive myeloma treatments that are associated with DVT risk are usually prescribed medication to reduce the likelihood of developing this condition. […] Hyperviscosity syndrome is considered a medical emergency and requires urgent treatment with plasmapheresis and exchange, a procedure that rapidly reduces the concentration of monoclonal proteins in the blood.

• #77 Course Content – #30714: Multiple Myeloma – NetCE

  https://www.netce.com/coursecontent.php?courseid=2760

  The emphasis placed upon the need for thorough hand washing and regular oral hygiene in patients with impaired immune systems is evidence of the fact that skin and mucous membranes provide physical barriers against infection. […] The destruction of bone associated with MM results in lytic lesions, with the potential for fractures. […] The ultimate goal in the treatment of hypercalcemia is to address the underlying disease. […] The most commonly offered treatment for spinal cord compression associated with multiple myeloma is emergent external beam radiation therapy following initiation of steroid therapy. […] The goals of SCC treatment are to manage the pain, stabilize the spine, and halt the underlying disease process to prevent irreversible neurologic damage. […] Nursing care of patients with MM and renal compromise is relatively involved.

• #78 Course Content – #30714: Multiple Myeloma – NetCE

  https://www.netce.com/coursecontent.php?courseid=2760

  The emphasis placed upon the need for thorough hand washing and regular oral hygiene in patients with impaired immune systems is evidence of the fact that skin and mucous membranes provide physical barriers against infection. […] The destruction of bone associated with MM results in lytic lesions, with the potential for fractures. […] The ultimate goal in the treatment of hypercalcemia is to address the underlying disease. […] The most commonly offered treatment for spinal cord compression associated with multiple myeloma is emergent external beam radiation therapy following initiation of steroid therapy. […] The goals of SCC treatment are to manage the pain, stabilize the spine, and halt the underlying disease process to prevent irreversible neurologic damage. […] Nursing care of patients with MM and renal compromise is relatively involved.

• #79 Course Content – #30714: Multiple Myeloma – NetCE

  https://www.netce.com/coursecontent.php?courseid=2760

  The emphasis placed upon the need for thorough hand washing and regular oral hygiene in patients with impaired immune systems is evidence of the fact that skin and mucous membranes provide physical barriers against infection. […] The destruction of bone associated with MM results in lytic lesions, with the potential for fractures. […] The ultimate goal in the treatment of hypercalcemia is to address the underlying disease. […] The most commonly offered treatment for spinal cord compression associated with multiple myeloma is emergent external beam radiation therapy following initiation of steroid therapy. […] The goals of SCC treatment are to manage the pain, stabilize the spine, and halt the underlying disease process to prevent irreversible neurologic damage. […] Nursing care of patients with MM and renal compromise is relatively involved.

• #80 Multiple Myeloma | Supportive Care for Multiple Myeloma | LLS

  https://www.lls.org/myeloma/treatment/supportive-care-and-disease-complications

  Supportive (palliative) care for myeloma helps manage the complications of the disease and the adverse side effects of the drugs used for treatment, including: […] Myeloma patients may have serious problems with their kidney function. Timely, adequate treatment of myeloma can improve kidney function and, potentially, even return it to normal in most cases. […] This is the term for damage to nerves of the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body and from the body back to the brain. […] Patients who receive myeloma treatments that are associated with DVT risk are usually prescribed medication to reduce the likelihood of developing this condition. […] Hyperviscosity syndrome is considered a medical emergency and requires urgent treatment with plasmapheresis and exchange, a procedure that rapidly reduces the concentration of monoclonal proteins in the blood.

• #81 Multiple Myeloma | Supportive Care for Multiple Myeloma | LLS

  https://www.lls.org/myeloma/treatment/supportive-care-and-disease-complications

  Supportive (palliative) care for myeloma helps manage the complications of the disease and the adverse side effects of the drugs used for treatment, including: […] Myeloma patients may have serious problems with their kidney function. Timely, adequate treatment of myeloma can improve kidney function and, potentially, even return it to normal in most cases. […] This is the term for damage to nerves of the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body and from the body back to the brain. […] Patients who receive myeloma treatments that are associated with DVT risk are usually prescribed medication to reduce the likelihood of developing this condition. […] Hyperviscosity syndrome is considered a medical emergency and requires urgent treatment with plasmapheresis and exchange, a procedure that rapidly reduces the concentration of monoclonal proteins in the blood.

• #82 Disease and Symptom Care: A Focus on Specific Needs of Patients With Multiple Myeloma | Oncology Nursing Society

  https://www.ons.org/disease-and-symptom-care-focus-specific-needs-patients-multiple-myeloma

  Patients with multiple myeloma (MM) often deal with short- and long-term side effects of the treatment and disease sequelae. […] Guidelines for nursing management of side effects in patients with MM are absent or require updating. […] Nurses function in a range of capacities on the front lines of patient care and hold vital roles, such as coordinators and facilitators of care. […] Therefore, nurses are well positioned to identify, intervene in, and effectively manage disease- and treatment-related symptoms in patients with MM, improving MM treatment quality, treatment adherence, and patient QOL. […] Effective symptom management is a critical component of treatment adherence in MM. […] The IMF NLB aims to improve the care and self-care of patients with MM and to create new professional activities, such as this supplement, and address the unmet needs of patients and the nurses who care for them. […] It is the hope of the IMF NLB that these peer-reviewed, evidenced-based recommendations will be accepted as a standard of nursing care for patients to manage short- and long-term side effects and symptoms and improve QOL.

• #83 Understanding and managing myeloma | Nursing Times

  https://www.nursingtimes.net/cancer/understanding-and-managing-myeloma-21-08-2014/

  Non-specialist nurses need to know how to care for patients with myeloma. […] Myeloma treatment includes: multi-drug chemotherapy regimens, which work synergistically; supportive treatments, such as bisphosphonates to protect against bone damage; and prevention and management of infection. Therefore, treatment plans are complex and present challenges to nurses and other health professionals caring for patients with myeloma. […] It is important to establish contacts with specialist colleagues, who can advise on patients specific myeloma-related needs. Specialists can also offer advice and guidance on the warning signs of myeloma-related complications or on signs that the disease is progressing. […] All patients with myeloma require supportive care. This is of critical importance in improving survival and quality of life for this group. Nurses play a vital role in patient education and in the early recognition of complications, such as infections or thrombosis, which need emergency treatment.

• #84 Current Diagnosis and Management of Multiple Myeloma

  https://www.cancernetwork.com/view/current-diagnosis-and-management-multiple-myeloma

  At every encounter, nurses should evaluate myeloma patients abilities to perform activities of daily living in a safe manner, so that falls and fractures are avoided. […] Nurses are in a unique position to assess and explore pain in a stepwise and ongoing fashion, using verbal and nonverbal pain scales and grading systems. […] Nursing care goals are to maintain or improve kidney function. […] Nurses can help to guide the myeloma patient and family through this long journey. […] Understanding the disease and its treatments allows the practitioner to ask pointed questions as part of the assessment. […] Advocating quality of life for patients includes patient education and support and coaching them to be self-advocates. […] Through exceptional care, oncology nurses can advocate for the patient with multiple myeloma to optimize treatment and quality of life outcomes.

• #85 Current Diagnosis and Management of Multiple Myeloma

  https://www.cancernetwork.com/view/current-diagnosis-and-management-multiple-myeloma

  At every encounter, nurses should evaluate myeloma patients abilities to perform activities of daily living in a safe manner, so that falls and fractures are avoided. […] Nurses are in a unique position to assess and explore pain in a stepwise and ongoing fashion, using verbal and nonverbal pain scales and grading systems. […] Nursing care goals are to maintain or improve kidney function. […] Nurses can help to guide the myeloma patient and family through this long journey. […] Understanding the disease and its treatments allows the practitioner to ask pointed questions as part of the assessment. […] Advocating quality of life for patients includes patient education and support and coaching them to be self-advocates. […] Through exceptional care, oncology nurses can advocate for the patient with multiple myeloma to optimize treatment and quality of life outcomes.

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