Clinical updates and nursing considerations for patients with multiple myeloma.

Multiple myeloma accounts for approximately 1% of all new cancers and is characterized by abnormal plasma cell proliferation in the bone marrow. As a result, many patients develop bone lesions, hypercalcemia, anemia, and renal impairment. Although no cure exists for multiple myeloma, current treatments, such as oral melphalan and prednisone, can slow disease progression and prolong overall survival. Several new therapeutic options show promise: lenalidomide, thalidomide, liposomal doxorubicin, and bortezomib. Clinical research presented at the 2006 meeting of the American Society of Hematology, the 2007 meeting of the American Society of Clinical Oncology, and the 11th International Myeloma Workshop showed that newer therapeutic combinations were well tolerated and effective in patients with multiple myeloma. Oncology nurses, with their specialized knowledge of treatment administration and monitoring and their expertise in patient education, have an important role in the management of patients with multiple myeloma to help improve overall survival and quality of life. As newer regimens become available, oncology nurses must be aware of factors that optimize outcomes to help patients understand the benefits of treatment, how to manage side effects, and the importance of treatment adherence.