Supportive care in multiple myeloma.

In myeloma bone disease, bisphosphonates have been shown to delay the progression of osteolytic lesions and prevent fractures. In the case of painful vertebral fractures, vertebroplasty and kyphoplasty have become standard procedures to control symptoms and restore the original height of the vertebrae. Adequate pain control is of crucial importance for the quality of life of myeloma patients, as is maintaining adequate hemoglobin levels with the use of erythropoietic growth factors. Infections should be treated aggressively in myeloma patients, as these contribute significantly to morbidity and mortality. In patients with repeated infectious complications, prophylactic measures such as long-term application of antibiotic or antiviral medication or use of intravenous immunoglobulins is recommended. The concerted action of these supportive therapies can significantly improve the wellbeing of myeloma patients in phases of disease progression as well as during phases of remission. In progressive disease, certain measures such as adequate pain control and radiotherapy can ameliorate symptoms until the therapeutic effect of systemic anti-neoplastic therapy becomes evident.