Supportive Treatment of Multiple Myeloma

Supportive Treatment of Multiple Myeloma

• Supportive treatment is the treatment that aim to treat the signs & symptoms or reduce them; it is not aim to treat the disease itself.

Renal Impairment :-

• Rehydrate.
• Treat the underlying cause (e.g. hypercalcemia, hyperuricemia).
• Dialysis.
• Drink at least 3 Liter of fluid daily (all multiple myeloma cases).

Bone disease and hypercalcemia :-

• Bisphosphonates (such as pamidronate, clodronate or zoledronic acid) reduce the progression of bone disease.
• Rehydration with isotonic saline, a diuretic and corticosteroids followed by a biphosphonate (to treat acute hypercalcemia).

Compression paraplegia :-

• Use decompression laminectomy or irradiation. 
• Also corticosteroid therapy may help.

Anemia :-

• Erythropoietin.
• Transfusion.

Bleeding (Bleeding caused by paraprotein interference with coagulation and hyperviscosity syndrome) :-

• May be treated by repeated plasmapheresis.

Infections :-

• Must treated rapidly.
• Prophylactic infusions of immunoglobulin concentrates together with oral broad - spectrum antibiotics and antifungal agents may be needed for recurrent infections.